LA-Aging Diversity Supplement

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Project Summary/Abstract OVERALL – PROJECT SUMMARY Obesity and type 2 diabetes are described as accelerators aging. There have been numerous attempts across decades to develop and validate measureable constructs for accelerated aging. We have conducted research supported by two prior successful NIDDK-funded diversity supplements to develop and apply deficit accumulation frailty indices to the first 8 years of follow-up in the Look AHEAD cohort, the span of time when all participants were assigned to active interventions. This has been a productive enterprise. We have published that:  The Look AHEAD intensive lifestyle intervention (ILI) created a buffer against increases in FI, roughly proportional to one year of aging in the control group  Among participants with relatively low FI at baseline, the ILI resulted in lower incidence of major cardiovascular disease events, however among participants with the highest FI scores at baseline, the ILI was associated with an increased incidence of cardiovascular events  The Look AHEAD ILI was equally ineffectual in preserving cognitive function across the full range of baseline FI  Greater increases in FI across 8 years was associated with subsequent increased risk for mortality and poorer trajectories of physical and cognitive function We propose to conduct a series of secondary data analyses, using the extensive data resources provided by the Look AHEAD cohort, 1) to extend the deficit accumulation FI originally developed by Look AHEAD through year 8 to the close-out of the Look AHEAD Extension (Year 18), producing FIE; 2) to develop a statistical bridge linking this FI with one being developed by the parent grant (LA-Aging) for years 19-23 of follow-up (FIA); and 3) to examine how trajectories of FIE are related to the prevalence of geriatric syndromes in the Look AHEAD Aging study. If successful, this project will provide a validated marker of long-term biological aging that can serve as an outcome measure in clinical trials and a tool for identifying factors that slow aging among older adults with type 2 diabetes and obesity. A complementary goal of this project is to further the development of Johnathan Ross, a promising undergraduate student at Winston-Salem State University, a historically black public research university. His primary mentor will be Dr. Mark Espeland, who is experienced and well-suited for this role. We respond to PA- 21-071 Research Supplements to Promote Diversity in Health-Related Research. Summary of Planned Contributions to the Look AHEAD Program. This request is attached to 1U01AG073697-01: Action for Health in Diabetes (Look AHEAD) Extended Follow-up (LA-Aging) Mark A. Espeland, PhD, Dual Principal Investigator.