Administrative Supplement Request to Lifespan Cardiovascular Risk Exposures and Alzheimer-related Brain Health

Sudden changes in cardiovascular (CV) risk factors, especially diet quality, physical activity attainment, andsleep hygiene, commonly accompany acute medical events such as surgeries among middle aged and olderadults. These sudden changes are associated with poorer long-term cognitive and brain outcomes. The Covid-19 pandemic caused a different version of sudden change: large numbers of healthy adults became confined tothe home for extended periods of time, changed their patterns of food shopping, restaurant eating, sports andexercise engagement, and sleep due to home confinement orders and their lingering after-effects. The Covid19pandemic is promoting a new and different form of sudden change in CV and lifestyle factors, the healthimpacts of which are not clear. Our immediate goal in this supplement is to rigorously assess the extent ofsudden CV risk factor changes associated with the Covid-19 pandemic, with a long-term goal of assessingrelationships between such cardiovascular changes and cognitive and brain changes in a large epidemiologicalcohort. This supplement will use validated technologies to objectively assess Covid-19-related changes to diet,physical activity, and sleep among black and white men and women in mid-life who have participated in theBogalusa Heart Study (BHS) participants, and already consented to longitudinal assessment of CV risk factors,brain outcomes, and cognitive outcomes via their enrollment in the parent grant (RO1 AG041200). We willprovide 250 BHS participants with wrist-worn accelerometers capable of assessing sleep quality and physicalactivity attainment (ActiGraph WGT3X+) as well as Remote Food Photography Methods© implemented via asmartphone application (the SmartIntake® app). Physical activity and sleep quality will be objectivelymeasured over a 7-day period, and food intake over a 4-day period. This data, together with previousassessments of diet, physical activity, and sleep quality from earlier sweeps through the cohort, will position usto calibrate and analyze changes in these three CV risk factors due to the Covid-19 pandemic. This data willposition us to assess effects of such sudden CV risk changes on cognitive and brain outcomes, as well as racedisparities in this association, to clarify the long-term public health impact of pandemic-related lifestylechanges. The data collected by this supplement efficiently leverages the parent grant (focused on CV risks andbrain outcomes) in a population with substantial minority representation (35% African-American) and couldidentify targets for a novel lifestyle intervention to be rapidly deployed and scaled in a future pandemic as away to preserve health. Leveraging the long-standing NIH investment in the Bogalusa Heart Study is theoptimal approach for investigating the effects of pandemic-related sudden CV risk factor changes on cognitiveand brain health.