Tirzepatide and Organ-specific Biological Aging

The purpose of this study is to evaluate blood-based measures of organ-specific biological age, with a particular focus on the brain, and to investigate their relationship with established clinical indicators of health and their response to treatment with tirzepatide.

Inclusion Criteria: * Stable medical status (neurological, cardiovascular, and immuno inflammatory) * Adults age 50-75 years * Eligible and waitlisted for brain health program onboarding * Willingness to undergo serial blood sampling, wearable monitoring, and MRI * Willingness to be assigned to the interventional trial or non-interventional trial * Willingness to accept tirzepatide treatment (interventional arm) Exclusion Criteria: * Major neurodegenerative disease (e.g., dementia) * Clinical and correlative imaging history of ischemic or hemorrhagic stroke * History of myocardial infarction (ACS) or heart failure * Significant inflammatory, autoimmune, or infectious disease or current treatments/interventions likely to distort proteomic aging measures * Contraindications to MRI * Currently taking tirzepatide * Pre-existing indications for tirzepatide (e.g., Type 2 diabetes, obesity, or obstructive sleep apnea) * BMI less than 20.0 * Known contraindication to tirzepatide, including a personal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2, or known serious hypersensitivity to tirzepatide * Active pancreatitis or history of recurrent pancreatitis * Severe gastroparesis * Clinically significant renal, hepatic, glycemic, or other laboratory abnormality that could increase the risk associated with tirzepatide treatment * Current use of insulin or insulin secretagogues (e.g., sulfonylureas) * Use of another incretin-based therapy unless discontinued for at least 35 days prior to enrollment * History of clinically significant intolerance to tirzepatide or another incretin-based therapy * Any other condition, illness, or medication that, in the judgment of the clinical investigative team, would make the individual an unsuitable candidate for tirzepatide or participation in this trial * Contraindication to a wearable ring * Pregnancy or lactation * Prisoners