 MATERIALS AND METHODS Database The Healthy Aging in Neighborhoods of Diversity across the Life Span HANDLS study is a prospective cohort study initiated in 2004 that focused on the cardiovascular and cognitive health of an ethnically and socio-economically diverse urban population. Specifically, it used area probability sampling to recruit a socioeconomically diverse sample of African American and White urban adults 30-64 years old residing in thirteen neighborhoods of Baltimore, Maryland.35 Written informed consent was obtained from participants who were also provided with a protocol booklet and a video that explains study procedures. The study protocol was approved by the National Institute on Environmental Health Sciences Institutional Review Board of the National Institutes of Health. Data for the present study were derived from baseline visit 1 2004-2009 and the first follow-up examination visit 2; 2009-2013. Follow-up time ranged from 1y to 8y, with a mean of 4.640.93y. 