Welcome to CVFS-SCAN

Chitwan Valley Family Study – Study on Cognition and Aging in Nepal

The CVFS-SCAN study aims to lay the foundation for a sustainable, population-based research program focused on Alzheimer's disease and related dementias (ADRD) and broader age-related health challenges in Nepal.

As Nepal's population ages, more adults are living longer, but with increased risk of cognitive decline, chronic conditions, and disability. Despite the rising burden of ADRD, there is currently limited national capacity to monitor, prevent, or manage these conditions, due to the absence of systematic data and a specialized research infrastructure.

To address this urgent gap, CVFS-SCAN leverages the longstanding Chitwan Valley Family Study (CVFS), a respected and nationally recognized longitudinal study that began in 1995. With decades of detailed family, community , and life history data, CVFS provides a unique foundation for launching a new wave of dementia-focused research tailored to Nepal's specific historical, social, and demographic context.

Overall Goal

To develop a foundation for sustained, high-quality, population-based research into ADRD and other age-related chronic conditions in Nepal.

Objectives

Build capacity in Nepal for the conduct of systematic, population-based research on Alzheimer’s disease and related dementias.
Develop and implement a new, longitudinal cohort study of ADRD and related aging-associated health conditions among older adults in Nepal.

Specific Aims

Build research capacity for the conduct of studies of ADRD and other aging-related changes in health. Specific capacity-building activities focus on:
- The design and administration of culturally appropriate cognitive assessments to identify ADRD in the general population.
- Building expertise in statistical methods for the analysis of longitudinal data from complex surveys.
Design and conduct a population-based study of ADRD and other age-associated conditions among 4,000 adults aged 50+ and their informants, including a baseline interview and a follow-up interview two years later.
Estimate the prevalence and incidence of ADRD and its primary clinical feature, cognitive impairment, and test associations between primary risk factors and ADRD/cognitive impairment and other relevant outcomes (e.g., disability, caregiving needs).
- In these analyses, we will test the specific hypotheses that longer duration of international labor migration and exposure to armed conflict are associated with an increased risk of ADRD and cognitive impairment.

Methodology

Study Design

A longitudinal cohort study of a representative sample of 4,000 older adults aged 50+ and their key informants from the Chitwan Valley Family Study (CVFS) panel, using a stratified two-stage cluster area probability sampling design.

Data Collection

Face-to-face interviews with respondents and informants. Data collection with Computer-Assisted Personal Interviewing (CAPI). Instruments include the Nepal Harmonized Cognitive Assessment Protocol (NHCAP) and a questionnaire covering basic and social demographics, life history events, health behaviors, and health assessments. An informant questionnaire to assess the respondents’ cognitive health and functioning.

Biomarker Collection

Draw of 30 ml blood sample by licensed phlebotomists using a vacuum extraction system following best practices.

What Makes CVFS-SCAN Unique

Integration with a Multigenerational Study

CVFS-SCAN draws on over two decades of data about participants' families, education, migration history, economic background, and health. Integration with the CVFS parent study offers a unique opportunity to investigate experiences and risk factors from the entire life-course that may affect cognitive aging and other indicators of declining health in old age.

Focus on Nepali-Specific Risk Factors

CVFS-SCAN is one of the first studies globally to test the role of labor migration and exposure to armed conflict as risk factors for ADRD, experiences that are common and often overlapping in Nepal.

Inclusive Design

CVFS-SCAN collects data not only from older adults aged 50+, but also from close family members or informants, an approach that enables the study of caregiving dynamics, intergenerational relationships, and shared decision-making in aging households.

Foundational Capacity-Building

CVFS-SCAN is building a platform to train the next generation of Nepali researchers in dementia science. Training includes cognitive assessment, biospecimen collection, survey management, and data analysis using longitudinal and multilevel techniques.

"Through CVFS-SCAN, Nepal joins the global effort to understand, track, and address dementia, ensuring that older adults can live with dignity, support, and opportunity in the years to come."

Timeline and Current Status

2022

The study began in 2022 and is projected to conclude by 2027.
Ethical approval from NHRC, Nepal received on December 20, 2022 (NHRC Ref No: 1334).
Adaptation and translation of survey instruments and cognitive test battery development process started.

2023

Iterative translation and expert review of survey instruments.
Focus Group Discussion on translation of study materials.
Trainers training on cognitive interviewing technique.
Piloting of venous blood collection, extraction, storage, and shipping.

2024

Cognitive interviews conducted with diverse respondents aged 50+ from various backgrounds to assess understanding of study questions and identify areas of confusion for further refinement.
Interviewer hiring and organized trainings (GIT, NHCAP, SST trainings and data analysis training).
Pre-testing of the survey instruments.

2025 Current Year

Refinement and finalization of survey instruments based on pre-test results.
Organized GIT, NHCAP, SST, and blood sample collection trainings for the final data collection.
Final data collection launched on February 20, 2025.

2026–27

Second wave of data collection.
Follow-up assessments that focus on assessing change in cognitive outcomes.
Analyze longitudinal patterns of cognitive decline and onset of ADRD.

Our Collaborators