Randomized Controlled Trial

. 2017 May;65(5):966-972.

doi: 10.1111/jgs.14692. Epub 2017 Jan 9.

Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study

Affiliations

¹ Department of Psychiatry and Behavioral Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
² Department of Medicine, Columbia University Medical Center, New York, New York.
³ Department of Epidemiology, Columbia University Medical Center, New York, New York.
⁴ Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
⁵ Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Division of Nutrition, Harvard Medical School, Boston, Massachusetts.
⁶ Department of Medicine, University of Texas Health Sciences Center, San Antonio, Texas.
⁷ Department of Psychiatry and Human Behavior, Miriam Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island.
⁸ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
⁹ Pennington Biomedical Research Center, Baton Rouge, Louisiana.
¹⁰ Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
¹¹ Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
¹² Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
¹³ Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charleston, Massachusetts.

PMID: 28067945
PMCID: PMC5435531
DOI: 10.1111/jgs.14692

Randomized Controlled Trial

Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study

Stephen R Rapp et al. J Am Geriatr Soc. 2017 May.

. 2017 May;65(5):966-972.

doi: 10.1111/jgs.14692. Epub 2017 Jan 9.

Authors

Affiliations

¹ Department of Psychiatry and Behavioral Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
² Department of Medicine, Columbia University Medical Center, New York, New York.
³ Department of Epidemiology, Columbia University Medical Center, New York, New York.
⁴ Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
⁵ Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Division of Nutrition, Harvard Medical School, Boston, Massachusetts.
⁶ Department of Medicine, University of Texas Health Sciences Center, San Antonio, Texas.
⁷ Department of Psychiatry and Human Behavior, Miriam Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island.
⁸ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
⁹ Pennington Biomedical Research Center, Baton Rouge, Louisiana.
¹⁰ Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
¹¹ Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
¹² Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
¹³ Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charleston, Massachusetts.

PMID: 28067945
PMCID: PMC5435531
DOI: 10.1111/jgs.14692

Abstract

Objectives: To assess whether randomization to 10 years of lifestyle intervention to induce and maintain weight loss improves cognitive function.

Design: Randomized controlled clinical trial.

Setting: Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Continuation study (U01 DK057136-15).

Participants: Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 (N = 3,751).

Intervention: Intensive lifestyle intervention (ILI) for weight loss through reduced caloric intake and increased physical activity compared with a control condition of diabetes support and education (DSE).

Measurements: Certified examiners who were masked to intervention assignment administered a standard battery of cognitive function tests (Modified Mini-Mental State Examination, Rey Auditory Verbal Learning Test, Digit Symbol Coding, Trail-Making Test, Modified Stroop Color-Word Test) to participants 10 to 13 years after enrollment.

Results: Assignment to lifestyle intervention was not associated with significantly different overall (P = .10) or domain-specific (all P > .10) cognitive function than assignment to diabetes support and education. Results were fairly consistent across prespecified groups, but there was some evidence of trends for differential intervention effects showing modest harm in ILI in participants with greater body mass index and in individuals with a history of cardiovascular disease. Cognitive function was not associated with changes in weight or fitness (all P > .05).

Conclusion: A long-term behavioral weight loss intervention for overweight and obese adults with diabetes mellitus was not associated with cognitive benefit. Trial Registration clinicaltrials.gov Identifier: NCT00017953.

Keywords: cognition; diabetes mellitus; intervention; obesity; weight loss.

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Conflict of interest statement

Conflict of Interest Disclosures: Below is a checklist for all authors to complete and attach to their papers during submission.


Elements of Financial/Personal Conflicts	SRR		JAL		LDB		GLB, HPH, KED-McD, RWJ, JNK, JMMcC, NMP, ME, TAW, SEA, MAE

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Figures

**Figure 1**
CONSORT diagram describing participant’s enrollment into Look AHEAD and those with available cognitive function assessments in Years 10–13.

See this image and copyright information in PMC

References

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Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study

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Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study

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Conflict of interest statement

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