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

基本信息

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
项目类别：
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&apos s Disease Alzheimer&apos s disease related dementia Alzheimer&apos 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

项目摘要

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器官的脆弱性。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、情绪控制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）和早逝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，这项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根据他们的意见，我们提出了一项创新的随机对照试验。我们称之为“健康老龄化的我的目标”。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。此外，我们将维护一个与电子数据相关的持续数据集，以便它能够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完成这些目标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型干预措施消除 AD/ADRD 等慢性疾病的差异。