Action for Health in Diabetes (Look AHEAD) Extended Follow-up (LA-E2)

糖尿病健康行动（前瞻性）延长随访 (LA-E2)

• 批准号: 10293012
• 负责人: MARK Andrew ESPELAND
• 金额: $ 150万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10293012
• 关键词: Adult; Aging; Ancillary Study; Behavior; Behavior Therapy; Behavioral; Behavioral trial; Biological Aging; Blood Pressure; Body Weight decreased; Caloric Restriction; Cardiovascular Diseases; Caring; Chronic Disease; Chronic Kidney Failure; Clinical; Control Groups; Counseling; Data; Development; Diabetes Mellitus; Diet; Education; Elderly; Enrollment; Ethnic Origin; Event; Face; Gender; Glycosylated hemoglobin A; Goals; Health; Health Status; Healthcare; Heterogeneity; Individual; Insulin; Interest Group; Intervention; Investigation; Lead; Life; Life Experience; Long-Term Effects; Longevity; Measures; Mediating; Medicare; Mental Depression; Metabolic; Metformin; Monitor; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Overweight; Participant; Pharmaceutical Preparations; Phenotype; Physical Function; Physical activity; Positioning Attribute; Predictive Factor; Prognosis; Protocols documentation; Race; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Resources; Risk; Risk Factors; Source; Specific qualifier value; Subgroup; Syndrome; Telephone Interviews; Time; Translating; United States; Weight; Weight maintenance regimen; adult obesity; age related; base; cognitive function; cohort; comparison intervention; cost; depressive symptoms; design; disability; disability risk; follow-up; frailty; health care service utilization; health related quality of life; healthy aging; high risk; improved; indexing; intervention effect; lifestyle intervention; middle age; multiple chronic conditions; resilience; response; sex; study population; therapy design

Type 2 diabetes mellitus is common among older individuals in the United States, with 26.7 million cases projected by 2050, an almost 4.5-fold increase from 2005, and the vast majority of these individuals have overweight or obesity. Type 2 diabetes and overweight/obesity are often described as accelerators of biological aging due to associations with decreased lifespan, increased disability risk, and reduced health-related quality of life. Yet, not all individuals with these conditions face the same prognosis in later life, and some continue to maintain relatively high levels of function and independence. This suggests that strategies could be identified to promote healthier later-life experiences. It is natural to consider that behavioral intervention to promote and maintain weight loss may mitigate against the consequences of aging. We propose to conduct the Look AHEAD Extension-2 (LA-E2) in response to RFA-AG-21-028 Limited Competition for the Continuation of the Look AHEAD Study, which emphasizes “assessing important health- related outcomes over time” in a cohort that has been extensively characterized over 18 years, with an emphasis on “outcomes that are relevant to healthy aging and resilience; major health events; healthcare utilization; and relevant behavioral and other factors that predict, mediate, or otherwise inform the long-term health effects of a multi-domain lifestyle intervention designed to produce and maintain weight loss in aging adults with type 2 diabetes mellitus.” We plan to enroll approximately 2600 Look AHEAD participants who had been randomly assigned to 10 years of either Intensive Lifestyle Intervention that successfully induced and maintained weight loss or a comparator condition of Diabetes Support and Education. These individuals will be followed for 4 additional years, using telephone interviews and Medicare linkage, to assess the legacy of this intervention on important later-life outcomes. The RFA targets five domains of outcomes: 1) Multimorbidity, 2) Physical function, 3) Cognitive function, 4) Health care utilization and costs, and 5) Health related quality of life and health status. These goals and outcomes frame our primary aims. We also have important secondary aims, as specified in the RFA, “to study the heterogeneity of diabetes and chronic disease development in this well-characterized, diverse study population.” We will describe how later-life outcomes are associated with clinical measures, medication use, and behaviors and how intervention effects vary among individuals depending on their gender, race/ethnicity, age, obesity, and health status. We will also maintain the Look AHEAD cohort as a source of discovery by promoting ancillary studies, dissemination, and the distribution of well-documented public use data, and through scientific interest groups. Our overarching goal is to provide information that is vital for improving the care of older individuals with type 2 diabetes mellitus and overweight or obesity.

2型糖尿病在美国的老年人中很常见，有2670万例 预计到2050年，比2005年增加了几乎4.5倍，这些人中的绝大多数 超重或肥胖症。 由于与寿命降低，残疾风险增加以及与健康相关的质量降低而导致的老化 生活。 保持相对高的功能和独立性。 为了促进更健康的后期经验。 保持体重减轻可能会减轻衰老的持续性手段。 我们建议根据RFA-21-028 Limited转换Extension-2（LA-E2）的外观 在未来的研究中竞争内容的竞争，该研究强调“评估重要的健康 - 随着时间的流逝，相关结果”在一个在18年中广泛特征的同类中， 强调“与健康衰老和韧性相关的结果；重大健康事件；医疗保健） 利用和相关行为和其他预测的因素 多域生活方式干预的健康影响，旨在产生和保持衰老的体重减轻 2型糖尿病的成年人。 被随机分配到成功不合理的十年密集生活方式干预措施和 保持体重减轻或糖尿病支持和教育的比较状况。 紧随其后的4年，使用电话采访和Medicare链接来评估此的遗产 干预重要的后期结果。 RFA的目标五个域：1）多轴测，2）身体功能，3）认知功能，4） 医疗保健利用和成本，以及5）与生活和健康状况有关的健康 结果构成了我们的主要AMS。 在这项良好的，多样的研究中，糖尿病和慢性病的异质性 人口。 和行为以及个体之间的干预如何根据性别，种族/种族， 年龄，肥胖和健康状况。 促进辅助研究，传播以及有据可查的公共用途数据的分布以及数据 通过科学利益群体。 我们的总体目标是提供信息，对于改善具有类型的老年人的护理至关重要 2糖尿病，超重或肥胖。