Supplemental Funding Request for RF1 AG062309 Early life glycemic status and Alzheimer's disease neuroimaging markers in middle age: the Bogalusa Heart Study

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The parent study (R01AG062309) examines associations between lifespan cardiometabolic exposures and midlife brain structure and function, as well as midlife cognitive function, in the bi-racial, semi-rural Bogalusa Heart Study (BHS). The importance of the main study is that it clarifies which cardiometabolic exposures influence the brain health of a socioeconomically diverse group of African American and white individuals at the portion of the lifespan (the 50s and early 60s) when cognitive and brain health begins to become more heterogeneous and begins to include clinically- significant cognitive decline in a large number of persons. This supplement adds three additional cardiometabolic exposures to the set of exposures we will examine: sudden reductions in physical activity, diet quality, and sleep quality caused by Covid-19 related home confinement. BHS participants will receive the same set of diet, physical activity, and sleep questionnaires that are assessed at each of their prior BHS study visits, along with a new survey specifically designed to identify Covid19-related changes. There is an extreme time urgency to assessing such confinement-related sudden lifestyle changes: BHS participants are confined to the home now, and are therefore able to assess their own confinement-related lifestyle changes now, rather than rely on error-prone recall of distal events. The supplement significantly enhances the parent study by providing data on exactly the sort of sudden, event-driven cardiometabolic changes that are important to long-term outcomes, but are typically missed by a longitudinal cohort study such as BHS, whose structure lends itself to measuring slowly-varying changes over the course of years. The supplement could clarify the importance of such sudden lifestyle changes to long-term health, relative to such slowly time-varying changes. In so doing, the supplement could clarify the importance of rapidly deploying lifestyle interventions to home-confined individuals to support high diet quality, physical activity attainment, and sleep quality in the event of a future pandemic.