The MyGoals for Healthy Aging Multi-Center Randomized Controlled Trial

贫困与恶劣的生活条件、很少的锻炼机会以及难以获得健康的医疗服务有关。 这些食物共同对器官系统产生“磨损”。心理压力会增加 中枢神经系统中的神经元，可能会导致功能和体积的损失， 参与维持体内平衡的大脑（例如，血糖），计划任务，执行任务， 动机和情绪控制心理压力和营养不良会加速衰老过程， 并且可能表现为执行功能缺陷、糖尿病、肥胖、阿尔茨海默病/阿尔茨海默病- 相关痴呆（AD/ADRD）和早期死亡。与贫困相关的压力 加速老化是已知的，但没有经过证实的干预措施，以减缓快速老化的步伐， 贫困家庭。反贫困计划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），MyGoals for Employment Success， 使用经过验证的就业激励措施，并使用经过实地测试的辅导计划来解决执行功能缺陷。 该研究旨在评估与执行功能，经济福祉和 社会功能为了评估与衰老相关的结局，额外的干预时间和随访是 因为健康成果往往滞后于经济成果。 国家老龄化研究所提供了一年的资金用于队列维护和重新设计MyGoals 将就业成功纳入一项健康老龄化研究，干预时间为三年，随访时间为六年， 以及健康、衰老和认知指标。这一重新设计是与领先的 跨学科专家使用德尔菲方法，一个正式的过程，了解如何优化 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， 我们称之为“我的健康老龄化目标”。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。我们还将储存血液用于未来的“冷冻研究”， 衡量人类衰老的标准此外，我们将保持一个与电子数据相关联的持续数据集， 有可能衡量研究时间范围以外的结果，包括未来的收入和死亡率， 死因了这些目标的实现将为社会政策的能力提供基本证据， 影响与衰老相关的健康结果;我们的最终目标是测试一种新的干预措施， 消除慢性病，包括AD/ADRD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.