Genomic Outcomes of Metformin
Condition: Coronary Artery Disease; Mild Cognitive Impairment; Obesity, Abdominal; Hypertension
MeSH terms: Coronary Artery Disease; Obesity, Abdominal; Cognitive Dysfunction
Intervention: Metformin; Placebo
Intervention MeSH terms: Metformin
Phase: Phase 4
Study type: Interventional
Primary purpose: Health Services Research
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 30.0
Sex: All
Minimum age: 65 Years
Maximum age: 79 Years
Healthy volunteers: No

Summary:

      Medical scientists have found that people with diabetes who take the drug Metformin have less
      age-related disease than those taking other treatments and researchers believe it may prevent
      numerous diseases and conditions that effect older people. In addition, metformin extends
      lifespan in some animal models of human disease. The purpose of this study is to see if
      taking Metformin causes changes in blood cells consistent with improved health and longevity
      in people who do not have diabetes. In this study Metformin will be compared to placebo. A
      placebo is a substance, like a sugar pill, that is not thought to have any effect on a
      participants disease or condition. In this study participants will either receive the active
      study medication, Metformin or placebo which is not active. Placebos are used in research
      studies to see if the drug being studied really does have an effect.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Age 65 - 79

        Must meet criteria from one or more of the following groups:

        Group 1 (Can have 1 or 2 of these, but not all 3)

          -  History of coronary artery disease (MI/heart attack, stroke, heart failure, or
             peripheral artery disease)

          -  Cancer, with no active treatment in the last year

          -  MCI (MoCA >18<26 -inclusive of 1 point if <12 years of education Group 2

          -  Decline physical function (walking speed < 1 m/s) Group 3 (Either or both)

          -  Abdominal obesity (>88cm women, >102cm men) AND hypertension (treated or resting blood
             pressure >140/90

          -  Abdominal obesity (>88cm women, >102cm men) AND hyperlipidemia (treated or fasting
             total cholesterol >240 English literacy Willing to provide informed consent

        Exclusion Criteria:

          -  eGFR <45

          -  Type 2 diabetes (HbA1c>6.5) or type 1 diabetes

          -  Any tobacco or nicotine product use in the past year

          -  Low vitamin B12 Levels (< 300 pg/mL)

          -  Self-reported severe difficulty or inability to walk 400m or climb 10 steps (from Q 2
             and 19 on PAT-D)

          -  Self-reported difficulty or inability to perform basic ADL functions (from Q 10, 13,
             14, 16 on PAT-D)

          -  Excessive alcohol use (>14 drinks/week)

          -  Cancer requiring treatment in past year (except skin)

          -  Dementia - diagnosed and/or MoCA score <18

          -  Parkinson's or other neurological disease

          -  Chronic liver disease or cirrhosis

          -  End stage renal disease or on dialysis

          -  Rheumatic conditions (Rheumatoid arthritis, lupus, and any other autoimmune disease
             the -PI deems them to be ineligible for)

          -  Thyroid problems the PI deems them to be ineligible for

          -  Gout

          -  Involved in another interventional study

          -  Hemoglobin <8 or diagnosed with anemia

          -  Recent unintentional weight change (+/- 10 lbs. in the last 12 months)

          -  BMI <18.5

          -  Likely to not follow the protocol

          -  PI deems unfit to participate

          -  Already taking Metformin or any other drug intended to treat diabetes