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These are the third and fourth waves of the PREHCO project (Puerto Rican Elder Health Conditions study) and have been developed between 2021 and 2024 as a collaboration between the University of Alabama at Birmingham and the University of Puerto Rico. The project began as a cross-sectional study of the non-institutionalized population aged 60 years or older in Puerto Rico. These waves followed the survivors of the original participants at the beginning of the fieldwork and aimed to examine the predictors of cognitive decline, disability, and mortality. The fourth wave of this study extends the follow-up of PREHCO to between 21 and 22 years after the initial data collection and aims to examine the predictors of cognitive decline, disability, and mortality. PREHCO was designed as a study comparable to the Multicenter Project on Health and Well-being of Older Adults in Latin America and the Caribbean (SABE) developed by the Pan American Health Organization (PAHO) in several cities in Latin America, and with some studies carried out in the United States, mainly the Health and Retirement Study (HRS). For this purpose, a questionnaire was designed that included sections on health conditions, physical and mental disability, functionality, use of medicines, health needs and social services, access to and use of health services, abuse, migration, housing conditions, patterns of help from family, community and public and government agencies, and others. Since its inception, PREHCO has been funded with federal funds from the National Institute on Aging (NIA). Initially it was a project between the University of Wisconsin-Madison and the University of Puerto Rico from 2000-2009.