CORE D. BIOSPECIMENS AND SUPPLEMENTARY MEASURES SUMMARY / ABSTRACT The common theme for Core D (Biospecimens & Supplementary Measures) is to conserve and administer existing biospecimens and supplementary data collected during ASPREE, and oversee the continued generation of such data acquired through ASPREE-XT. These data relate to biological (and other) factors that influence health and disease in aging individuals, including neuroimaging for Alzheimer’s disease and related dementia (ADRD) structural pathology, and tumor specimens collected from participants who develop cancers. Core D will ensure that the specimens, images and other supplementary data will be perpetuated for future collaborations; all the while interacting closely with other Cores including Core B for clinical endpoint confirmation and Core C for Data Management. Core D consists of 2 main components which are critical to the success of the Aims proposed in the U19: (1) responsibility for biobanked biological samples including tumor tissue samples; (2) access to data from existing neuroimages to evaluate ADRD vs cerebrovascular pathology. The current and future collections of tumor tissues across both countries will be managed through Core D, which will provide the resources and expertise from the biorepositories in Australia and the U.S., linking closely with the endpoint team in Core B, responsible for providing the cancer cases for adjudication. Core D will also provide oversight of supplementary measures and provision of existing data obtained from biospecimens. Along with the Bi-National Administrative Core, Core D will contribute to the governance and decisions about biomarker access and analyses of samples. In collaboration with Core C through data storage and management, Core D will ensure that biomarker data are disseminated to the U19 for analysis related to cancer, dementia and other outcomes and include, but are not limited to, inflammatory biomarkers and genomic data (such as APOE allele data for ADRD-related studies). Core D will also manage storage and access to the collection of existing longitudinal MRI data to identify changes in neurodegenerative pathology consistent with ADRD versus vascular pathology collected in the following ASPREE substudies: ENVISion (aspirin for the prevention of cognitive decline in the Elderly: a Neuro-Vascular Imaging Study), SNORE-imaging (Study of Neurocognitive outcomes, Radiological and retinal Effects of Aspirin in Sleep Apnea) and NEURO (effect of LDA on number of cererbral microbleeds and correlation with cognitive function).