The MyGoals for Healthy Aging Multi-Center Randomized Controlled Trial

MyGoals 健康老龄化多中心随机对照试验

• 批准号: 10677637
• 负责人: Daniel Walker Belsky
• 金额: $ 59.35万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677637
• 关键词: Acceleration; Age; Aging; Algorithms; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Area; Automobile Driving; Behavioral; Biological; Biological Aging; Biological Assay; Blood; Blood Glucose; Blood specimen; Brain; C-reactive protein; Caring; Cause of Death; Central Nervous System; Cessation of life; Chronic Disease; Cognition; Cognitive; Cognitive Science; Collaborations; Collection; Consultations; Control Groups; Crime; DNA Methylation; Data; Data Collection; Data Linkages; Data Set; Development; Diabetes Mellitus; Diet; Disadvantaged; Economics; Emotional; Employment; Executive Dysfunction; Exercise; Family; Funding; Future; Genes; Glycosylated hemoglobin A; Goals; Health; Health Food; Health Insurance; Health Status; Health behavior; Height; Homeostasis; Housing; Human; Human Resources; Incentives; Income; Individual; Intervention; Investigation; Laboratories; Link; Loneliness; Longevity; Maintenance; Measures; Medical; Memory; Mental Depression; Mental Health; Methodology; Methods; Moods; Motivation; National Institute on Aging; Neurons; Obesity; Outcome; Outcome Assessment; Outcome Measure; Participant; Pathway interactions; Personal Satisfaction; Persons; Phase; Population; Poverty; Premature aging syndrome; Process; Psyche structure; Psychological Stress; Psychologist; Public Housing; Randomized; Randomized, Controlled Trials; Records; Research; Resources; Risk; Services; Sleep; Social Functioning; Social Policies; Social outcome; Stress; Surveys; System; Testing; Time; Unemployment; United States Dept. of Health and Human Services; Weight; Work; age related; biobank; blood pressure regulation; body system; cohort; dementia risk; design; diet and exercise; disparity elimination; disparity reduction; economic outcome; electronic data; executive function; field study; follow-up; frailty; health disparity; health related quality of life; healthy aging; improved; innovation; interdisciplinary approach; intervention effect; loss of function; methylation pattern; minority investigator; mortality; neural; novel; nutrition; patient engagement; physical conditioning; prevent; programs; randomized trial; research and development; social; social health determinants; success; treatment group; welfare; whole genome

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.

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机会有关。 共同对器官系统产生“磨损”的食物。心理压力会增加人的脆弱性 中枢神经系统中的神经元，可能会导致以下区域的功能和体积丧失 参与维持体内平衡（例如血糖）、计划任务、执行任务的大脑， 动机和情绪控制。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）和过早死亡。贫困相关压力的机制 加速衰老是众所周知的，但没有经过证实的干预措施可以减缓衰老的速度 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)“我的就业成功目标”对贫困进行干预 使用经过验证的就业激励措施，并使用经过现场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果，需要额外的干预时间和随访 之所以需要，是因为健康结果往往滞后于经济结果。 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 就业成功进入一项健康老龄化研究，为期三年的干预时间，六年的随访， 以及健康、衰老和认知测量。此次重新设计是与领先的合作完成的 跨学科专家使用德尔菲法，这是一种了解如何优化的正式流程 措施选择和措施收集的时间。根据他们的意见，我们提出了一项创新性随机对照试验 我们称之为“我的健康老龄化目标”。我们将衡量干预措施对心理压力、饮食、 睡眠、情绪、孤独感、身高、体重、执行功能、血糖、高敏 C 反应蛋白和 基因甲基化模式。我们还将储存血液用于未来的“冷冻研究”，以便进行更复杂的研究 人类衰老的衡量标准。此外，我们将维护一个与电子数据链接的持续数据集，以便 可以衡量研究时间范围之外的结果，包括未来的收入和死亡率 死亡原因。这些目标的完成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减少的新颖干预措施 消除 AD/ADRD 等慢性疾病的差异。