Effect of a long-term intensive lifestyle intervention on cognitive function: Action for Health in Diabetes study
Open accessAbstract
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 ( NCT 00017953) and Look AHEAD Continuation study (U01 DK 057136‐15). 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: NCT 00017953.
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Cognitive function was not related to group allocation or to weight loss in the Look AHEAD study.
“Cognitive function was not related to group allocation or to weight loss.”
From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [184]
In the Look AHEAD study, there was a strong inverse relationship between HbA1c concentration and cognition over both groups.
“There was a strong inverse relationship between HbA1c concentration and cognition over both groups.”
From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [184]
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Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission
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- Authors
- Rapp, S. R., Luchsinger, J. A., Baker, L. D., Blackburn, G. L., Hazuda, H. P., Demos‐McDermott, K. E., Jeffery, R. W., Keller, J. N., McCaffery, J. M., Pajewski, N. M., Evans, M., Wadden, T. A., Arnold, S. E., Espeland, M. A., & the Look AHEAD Research Group
- Affiliations
- Wake Forest University Health Sciences (US)
- Columbia University Irving Medical Center (US)
- Beth Israel Deaconess Medical Center (US)
- The University of Texas at San Antonio Health Science Center (US)
- Department of Psychiatry and Human Behavior Miriam Hospital and Alpert School of Medicine Brown University Providence Rhode Island
- University of Minnesota (US)
- Pennington Biomedical Research Center (US)
- Brown University (US)
- National Institutes of Health (US)
- University of Pennsylvania (US)
- Harvard University (US)
- Corresponding author
- Rapp, Stephen R.
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2017-01-09
- Volume
- 65
- Issue
- 5
- Pages
- 966-972
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC5435531
- OpenAlex
- W2570701502
- Cited by
- 62
- References
- 37
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 2 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 8 · 2019: 5 · 2018: 7 · 2017: 5
- FWCI
- 5.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- intensive lifestyle intervention, cognitive function, type 2 diabetes, weight loss, obesity, diabetes support and education, cognitive decline, body mass index, cardiovascular disease history, Look AHEAD trial
- MeSH terms
- Aged, Behavior Therapy, Cognition, Diabetes Mellitus, Type 2, Female, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Obesity, Patient Education as Topic, Psychiatric Status Rating Scales, Weight Loss, Exercise, Treatment Outcome
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