This analysis was based on the COGA Prospective Study Dataset (22). Ascertainment sites were University of Connecticut (Farmington, CT), Indiana University School of Medicine (Indianapolis, IN), University of Iowa (Iowa City, IA), Washington University in St. Louis (St. Louis, MO), State University of New York Downstate (Brooklyn, NY), Howard University (Washington, DC), and University of California San Diego (San Diego, CA). All participants provided informed consent for study procedures. All protocols were approved by institutional review boards at the various institutions.