The MyGoals for Healthy Aging Multi-Center Randomized Controlled Trial

贫困与恶劣的生活条件、很少的锻炼机会和很难获得健康相关 集体对器官系统产生“磨损”的食物。心理压力增加了人的脆弱性 中枢神经系统中的神经元，潜在地在中枢神经系统造成功能和体积的丧失 参与维持动态平衡(如血糖)、计划任务、执行任务、 动力和情绪控制。心理压力和营养不良会加速衰老过程， 并可能表现为执行功能障碍、糖尿病、肥胖症、阿尔茨海默病/阿尔茨海默病- 相关痴呆症(AD/ADRD)和过早死亡。与贫困相关的压力产生的机制 加速衰老是已知的，但还没有得到证实的干预措施来减缓 贫困的家庭。反贫困项目是一个合乎逻辑的干预点。 一项正在进行的随机对照试验(RCT)--我的就业成功目标--干预了这两个贫困 使用已证实的就业激励措施，并使用经过现场测试的教练计划来解决执行功能缺陷。 这项研究旨在评估与执行功能、经济幸福感和 社交功能。为了评估与老龄化相关的结果，额外的干预时间和随访包括 这是必要的，因为健康结果往往滞后于经济结果。 国家老龄研究所为队列维护和重新设计MyGoals提供了一年的资金 为就业成功纳入健康老龄化研究，干预时间为三年，随访六年， 以及健康、衰老和认知指标。这次重新设计是与Leading合作完成的 使用Delphi方法的跨学科专家，这是一个了解如何优化的形式化过程 测量选择和测量收集的时间。在他们的投入下，我们提出了一个创新的RCT 我们称我的目标为健康老龄化。我们将测量干预对心理压力、饮食、 睡眠、情绪、孤独、身高、体重、执行功能、血糖、高敏C反应蛋白，以及 基因甲基化模式。我们还将为未来的“冷冻室研究”储存血液，以便进行更复杂的研究。 人类老龄化的衡量标准。此外，我们将维护一个与电子数据相关联的持续数据集，以便它 有可能衡量研究时间框架之外的结果，包括未来的收入和死亡率 死因是。这些目标的实现将为社会政策的能力提供基础证据 影响与衰老相关的健康结果；我们的最终目标是测试一种可能减少或 消除包括AD/ADRD在内的慢性病的差异。

Poverty is associated with harsh living conditions, few opportunities to exercise, and poor access to healthy food that collectively produce “wear and tear” on organ systems. Psychological stress increases the fragility of neurons in the central nervous system, potentially producing both the loss of function and volume in areas of the brain that are involved in maintaining homeostasis (e.g., blood glucose), planning tasks, executing tasks, motivation, and emotional control. Psychological stress and poor nutrition can accelerate the aging process, and may manifest as executive function deficits, diabetes, obesity, Alzheimer's disease/Alzheimer's disease- related dementias (AD/ADRD), and early death. The mechanisms by which poverty-associated stress accelerates aging are known, but there is no proven intervention to slow the rapid pace of aging among impoverished families. Anti-poverty programs are a logical point of intervention. An ongoing randomized-controlled trial (RCT), MyGoals for Employment Success, intervenes on both poverty using proven employment incentives and on executive function deficits using a field-tested coaching program. That study was designed to evaluate outcomes associated with executive function, economic well-being, and social functioning. To evaluate outcomes associated with aging, additional intervention time and follow up are needed because health outcomes tend to lag economic outcomes. The National Institute on Aging provided one year of funding for cohort maintenance and to re-design MyGoals for Employment Success into a healthy aging study with three years of intervention time, six years of follow up, and health, aging, and cognition measures. This re-design was done in collaboration with leading interdisciplinary experts using the Delphi method, a formalized process for understanding how to optimize measure selection and the timing of measure collection. With their input, we propose an innovative RCT that we call MyGoals for Healthy Aging. We will measure the effect of the intervention on psychological stress, diet, sleep, mood, loneliness, height, weight, executive function, blood sugar, high-sensitivity C-reactive protein, and gene methylation patterns. We will also store blood for future “freezer studies” that allow for more sophisticated measures of human aging. In addition, we will maintain an ongoing dataset linked to electronic data so that it is possible to measure outcomes beyond the time frame of the study, including future income and mortality by cause of death. Completion of these aims will provide foundational evidence on the ability of social policy to influence aging-related health outcomes; our ultimate goal is to test a novel intervention that might reduce or eliminate disparities in chronic diseases including AD/ADRD.