SWAN-Aging is designed to determine the extent to which midlife health and characteristics of the menopause transition (MT) affect successful aging in women, including the rate of cognitive decline and the risk of dementia and disability. Studies on aging highlight the midlife (age 40-65 years) as a critical life stage for prevention of cognitive impairment, Alzheimer’s disease, Alzheimer’s disease related dementia, physical disability and multi-morbidity in old age. This U19 proposal will extend follow-up of the Study of Women’s Health Across the Nation (SWAN), a longitudinal study initiated in 1994 to characterize the physiological and psychosocial changes that occur during the MT, into early old age (66-75 years). It will expand data collection to link midlife health characteristics and modifiable risk factors to early and rapid cognitive decline, incidence of mild cognitive impairment, cardiac health, and physical function in early old age. SWAN-Aging will leverage the existing SWAN scientific expertise and organizational structure to create three integrated Projects. Project 1 will evaluate the impact of MT characteristics and midlife health indicators on preservation of cognitive function (avoiding cognitive decline and onset of mild cognitive impairment), sleep, genitourinary and sexual function, and quality of life in early old age; Project 2 will test how the MT relates to cardiac health and cardiovascular disease (CVD) events in women in early old age and test how cardiac health relates to early markers of physical impairment, Alzheimer’s disease, and vascular dementia at a critical period in the lifespan; and Project 3 will examine the role of the MT and midlife characteristics on musculoskeletal health and physical functioning. The specific aims of Administrative Core (Core 1) are to: 1) Provide leadership, strategic planning, and organizational infrastructure for SWAN-Aging; 2) Facilitate investigator interaction, creativity, and productivity; 3) Disseminate SWAN and SWAN-Aging results and enhance translation; 4) Ensure broad use of SWAN data and support career development; and 5) Monitor and protect participant safety. Core 1 will coordinate and support research efforts across the Projects and Cores and will supply the required resources to execute study operations. Core 1 will support an Integrative Sciences Committee that will facilitate cross-cutting investigations of the interrelationships between cognitive, cardiac, and physical function, and their joint impact on activities of daily living disability. Core 1 will also lead a new Translation and Dissemination Committee in which experts in women’s health will develop methods for disseminating rigorous research results focused on the enhancement of physical health and the prevention of dementia and disability for clinical and lay communities. The Administrative Core will provide the structure required for the SWAN-Aging Projects to successfully conduct their studies, prod...