Bio-medical and socio-economic precursors of cognitive decline in SHARE.

The general aim of SHARE-HCAP is to exploit the international variation of health and life circumstances in Continental Europe to identify which interactions of bio-medical and socio-economic conditions over the life course affect cognition in later life. The understanding of such life-course pathways to first mild cognitive impairment and then, possibly, dementia, should help in developing preventive early interventions.

The project will enhance our understanding how the vastly differing social, health and long-term care systems affect mental health and resulting mortality of the aging populations. This holds especially for the life circumstances in Europe since World War II which are likely to have influenced cognitive decline now at older ages. Moreover, the large variation in key policy variables, e.g. retirement age, identifies pathways from early retirement through inactivity and loss of social contacts to lower cognition, mediated by education, working environment and other socio-economic factors over the life-course.


The project will administer in-depth measurement of cognition according to the Harmonized Cognitive Assessment Protocol (HCAP) that has been developed for the HRS-style ageing surveys. HCAP consists of a recently developed battery of in-depth cognition measures. More specifically, it consists of about one hour of subject cognitive testing and a twenty-minute informant interview, both of which can be administered in the home or care facilities by survey interviewers with advanced training.

The measures included in HCAP were selected by three criteria: (a) can be administered in the home by a survey interviewer in about one hour, (b) can be administered comparably and lead to comparably valid assessments in other countries where HRS-type surveys are conducted, and (c) has sufficient overlap with the 2002/03 HRS-ADAMS study that it can be used to establish trends in the prevalence of cognitive impairment in the US. Using these data, the project will estimate prevalence rates of mild and severe cognitive impairment in the SHARE countries; compare these with HRS and other participants in the HCAP studies; and exploit the international variation of the SHARE plus SHARE-HCAP data in order to identify which interactions of biomedical and socioeconomic conditions over the life course affect cognition later in life.


The project will be implemented in five SHARE countries (Denmark, Czech Republic, Germany, France, Italy) in a stratified study sample of 2,500 SHARE panel respondents. The start of the fieldwork is planned by early 2022. Versions of HCAP will also be conducted in the US, Mexico, India, China, and South Africa. For more information on the HCAP Network visit: 



The project receives funding unter grant number 5R01AG056329.