Bateman et al., NOT-AG-20-022 2020 PROJECT SUMMARY The proposed administrative supplement will fund an investigation of the impact of COVID-19 on participants of the Wake Forest Alzheimer’s Disease Research Center (ADRC). We will determine the impact of COVID-19 related social distancing and stress on individuals with cognitive impairment as compared to older adults with normal cognition in the WF ADRC center cohort. The proposed supplement will be conducted in the Clinical Core cohort of the ADRC at Wake Forest School of Medicine, and falls within the general scope of the ADRC of identifying factors that modulate cognitive decline in aging and Alzheimer’s disease, and synergizes with our center’s focus on health disparities by utilizing a metric of neighborhood disadvantage. The proposal is based on evidence that loneliness and stress are associated with cognitive decline and are expected to be more prevalent as a result of social distancing public health measures for the prevention of COVID-19 spread. Several prior studies have shown that loneliness is associated with chronic stress in older adults, and that loneliness is further associated with cognitive decline, with some suggestion of a bidirectional relationship. Loneliness has been shown to be affected by neighborhood variables as well. Our proposed supplement will examine the impact of COVID-19 on loneliness and stress, and determine whether participants with pre- pandemic cognitive impairment, or those living in more deprived neighborhoods, are more vulnerable to the impact. There are two parts to our proposed study: a telephone-based questionnaire visit and dried blood spot collection for transcriptional analysis. We will collected two questionnaires focused on the impact of COVID-19, as well as questionnaires to assess perceived stress, loneliness, coping strategies, and psychological well- being. Each participant will be geocoded and their area deprivation index will be obtained based on publically- available data. A new collaborative relationship has been established with the UCLA Social Genomics Core which will perform the RNA extraction and analysis. 1