Early-life disadvantage impedes normal developmental trajectories and confers elevated risk for poor health, personal, and financial consequences that are particularly pronounced for individuals in mid-life. This is a significant public health issue in impoverished communities that disproportionately suffer aging-related negative outcomes. Unfortunately, current interventions target single primary clinical outcomes rather than a target mechanism of various aging-related consequences, and are thus limited. This application seeks to target elevated delay discounting (DD), a core mechanism for these negative consequences in mid-life. Indicative of exaggerated preference for immediate rewards, elevated DD is associated with a wide spectrum of health- compromising behaviors and negative outcomes observed in mid-life of individuals with early-life disadvantage. Using a computerized executive function (EF) training intervention in a context of a small-scale Stage-II RCT design, this application seeks to experimentally examine changes in EF and DD in a sample of mid-life individuals who have experienced early-life disadvantage. Primary Aims are to examine initial and maintained (6 month) effects of 15 training sessions on both EF and DD, in contrast to a matched control training condition and a no training condition. We expect EF improvement and reductions in DD immediately and 6-months following the active training condition but not in the control or no training conditions. An Exploratory Aim is to examine if improvements in EF is a mechanism of intervention effects on DD. We expect that reductions in DD will be mediated by improvement in EF. The proposed research may illuminate an innovative approach that may be particularly applicable to impoverished communities and broadly impact the health and wellness of mid-life individuals with increased risk for poor consequences due to early-life disadvantage.

Public Health Relevance

Mid-life Individuals with early-life disadvantage disproportionately suffer aging-related negative outcomes. The proposed intervention seeks to help mid-life individuals prioritize delayed consequences of current behaviors in order to improve decision making involving intertemporal tradeoffs. Targeting this mechanism of aging-related adverse outcomes and behaviors may broadly address mid-life negative consequences.

National Institute of Health (NIH)
Research Project (R01)
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Special Emphasis Panel (ZAG1)
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Nielsen, Lisbeth
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University of Maryland College Park
Schools of Arts and Sciences
College Park
United States
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