Project Summary Building on research to assess risk factors for atherosclerotic cardiovascular disease (CVD) in transgender populations, the proposed project uses methods validated in the parent grant to characterize dementia, including Alzheimer’s Disease, in transgender populations. The project’s main aim will be to use a robust method of identifying transgender individuals within claims data to assess rates of dementia diagnoses among transgender persons compared to cisgender referents. Completing the proposed aims will 1) demonstrate the utility of prior work by utilizing methods validated in the parent grant; 2) reveal further evidence in a unique population of traditional risk factors for cardiovascular disease that are linked dementia; and 3) inform future research into aging and dementia prevention in transgender populations. By engaging in mentored research with Drs. Emelia Benjamin (Mentor), Michael Paasche-Orlow (Mentor), Howard Cabral (Mentor), and Sari Reisner (Mentor), and collaborators, and participating in seminars, conferences, and regular mentoring meetings, I will develop expertise in four new areas critical to my development as an independent clinician- scientist evaluating health outcomes to characterize and mitigate CVD and dementia risks for transgender individuals: 1) Quantitative methods to analyze claims-based & electronic health record data; 2) Quantitative methods to assess prediction models; 3) Clinical skills in transgender endocrinology, cardiology, & preventive care. Moreover, I will extend my grant writing and oral presentation skills by participating in grant writing courses and presenting at research meetings and seminars. Boston University offers junior scholars with the intellectual and practical resources they need to develop into successful independent investigators, including junior faculty seminars, grant writing, editing, and review services, and opportunities for intellectual exchange and collaboration with senior colleagues. An administrative supplement to my K01 award will provide me with the research experience, skills, and mentorship I need to build a cutting-edge independent research program that assesses and addresses cardiovascular health and its effects on additional outcomes such as dementia in sexual and gender minorities, particularly transgender adults.