Evaluation of sensory impairment in individuals with MCI or AD Sensory impairments are associated with cognitive decline in older adults, h o w e v e r , these associations are complex and can exhibit bidirectionality. A recent Lancet Commission examined hearing loss as one of several potential modifiable risk factors for dementia, calculating its risk-adjusted population attributable fraction (PAF) in a community-based study of British adults7. The estimated PAF for hearing loss in middle- aged adults 45-64 years of age was 9%, a value higher than any other examined modifiable risk factor; this value was also higher than the PAF estimate for the APoE e4 allele (8%). The overall goal of this work is to more fully characterize the sensory-cognitive relationship as it applies specifically to a diverse aging cohort of cognitively impaired individuals (MCI) at risk for further decline as well as those who are aging normally with little or no cognitive decline, and identify the genetic variation underlying these interactions. This administrative supplemental funding request is designed to add a sensory impairment test battery to our ongoing translational study with the following aims: Aim 1: To examine sensory and cognitive associations in older adults with mild AD and MCI. With our established relationship with the Aging Center we have access older adults diagnosed with MCI for the proposed studies to identify the key features of the sensory profile associated with MCI, diagnosed by a dementia adjudication team. Aim 2: To identify genetic variation associated with an increased risk and a trajectory of hearing loss in the context of cognition and physical function. Individuals will first be screened utilizing candidate genes from our established MiamiOtogenomic pipeline of over 200 genes in the two groups. Individuals without obvious candidate variants will then undergo whole exome/genome sequencing (WES/WGS). We have over 500 participants being longitudinally followed in NIH funded projects. Our sample is ethnically diverse as half of our sample is Hispanic and 10% are African American; 50% of our Hispanic group (Spanish is their dominant language) are of Cuban descent, 20% are from Puerto Rico, and 30% are from other Latin American Countries. We will use the identical clinical evaluation and traditional neuropsychological measures used in previous studies as highlighted in the Inclusion/Exclusion criteria below since we have extensive local norms for Hispanic, white Non- Hispanic, and African-American groups. We have already established a sensory disorders clinic associated in conjunction with this project and have the capability to see patients ages 50-90 years old from diverse racial/ethnic backgrounds on a weekly basis. Our minority focused Miami sensory screening pipeline, and database of genomic variation and phenotypes – sensory disorders and MCI will identify a sensory impairment battery for the early detection of MCI that can be incorporated...