CoChat
Sign Up
Cited by 64Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and ManagementPhysical Activity and Health

Impact of intensive lifestyle intervention on disability-free life expectancy: the Look AHEAD study

Open access
Gregg, Edward W., Lin, Ji, Bardenheier, Barbara, Chen, Haiying, Rejeski, W. Jack, Zhuo, Xiaohui, Hergenroeder, Andrea L., Kritchevsky, Stephen B. +5 more·2018·Diabetes Care
DOI 10.2337/dc17-2110PMC PMC5911793
Open this paper in CoChat — free accountOpen PDF

Abstract

OBJECTIVE The impact of weight loss intervention on disability-free life expectancy in adults with diabetes is unknown. We examined the impact of a long-term weight loss intervention on years spent with and without physical disability. RESEARCH DESIGN AND METHODS Overweight or obese adults with type 2 diabetes age 45–76 years (n = 5,145) were randomly assigned to a 10-year intensive lifestyle intervention (ILI) or diabetes support and education (DSE). Physical function was assessed annually for 12 years using the 36-Item Short Form Health Survey. Annual incidence of physical disability, mortality, and disability remission were incorporated into a Markov model to quantify years of life spent active and physically disabled. RESULTS Physical disability incidence was lower in the ILI group (6.0% per year) than in the DSE group (6.8% per year) (incidence rate ratio 0.88 [95% CI 0.81–0.96]), whereas rates of disability remission and mortality did not differ between groups. ILI participants had a significant delay in moderate or severe disability onset and an increase in number of nondisabled years (P < 0.05) compared with DSE participants. For a 60-year-old, this effect translates to 0.9 more disability-free years (12.0 years [95% CI 11.5–12.4] vs. 11.1 years [95% CI 10.6–11.7]) but no difference in total years of life. In stratified analyses, ILI increased disability-free years of life in women and participants without cardiovascular disease (CVD) but not in men or participants with CVD. CONCLUSIONS Long-term lifestyle interventions among overweight or obese adults with type 2 diabetes may reduce long-term disability, leading to an effect on disability-free life expectancy but not on total life expectancy.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.2337/dc17-2110

Cites

5 of 5 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Lifestyle intervention produced benefits on aging-relevant outcomes such as reductions in multimorbidity and improvements in physical function and quality of life.

    “In addition, lifestyle intervention produced benefits on aging relevant outcomes such as reductions in multimorbidity and improvements in physical function and quality of life (85-88).”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [88]

    The Results report less physical disability with intensive lifestyle intervention, and the Conclusions describe benefits in mobility and quality-of-life domains. The paper does not report a reduction in multimorbidity; its findings about disability and selected health outcomes do not establish that part of the claim. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Lifestyle intervention in Look AHEAD produced benefits on aging relevant outcomes, such as reductions in multimorbidity and improvements in physical function and quality of life.

    “In addition, lifestyle intervention produced benefits on aging relevant outcomes, such as reductions in multimorbidity and improvements in physical function and quality of life (92-95).”

    From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [95]

    The Conclusions report improved physical fitness and benefits in mobility, ambulation, and perceived health, supporting the physical-function and quality-of-life portions of the claim. They also mention reductions in chronic kidney disease and other health outcomes, but neither those passages nor the study’s disability findings establish a reduction in multimorbidity. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The Look AHEAD lifestyle intervention produced benefits on aging-relevant outcomes, including reductions in multimorbidity, improved physical function, and enhanced quality of life.

    “The lifestyle intervention also produced benefits on aging-relevant outcomes, including reductions in multimorbidity, improved physical function, and enhanced quality of life”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [106]

    The Incidence of Physical Disability section reports a lower rate of moderate or severe disability in the intervention group, and the Conclusions describe improved physical fitness and reported quality-of-life benefits, particularly mobility and perceived health. The paper does not report a reduction in multimorbidity, so that part of the claim is unsupported. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 20

  1. Nathan DM. Long-term complications of dia- betes mellitus. N Engl J Med 1993;328:1676-1685
  2. Gregg EW, Zhuo X, Cheng YJ, Albright AL, Narayan KM, Thompson TJ. Trends in lifetime risk and years of life lost due to diabetes in the USA, 1985-2011: a modelling study. Lancet Diabe- tes Endocrinol 2014;2:867-874
  3. Bardenheier BH, Lin J, Zhuo X, et al. Disability- free life-years lost among adults aged $50 years with and without diabetes. Diabetes Care 2016; 39:1222-1229
  4. Wong E, Backholer K, Gearon E, et al. Diabetes and risk of physical disability in adults: a system- atic review and meta-analysis. Lancet Diabetes Endocrinol 2013;1:106-114
  5. Guralnik JM, Fried LP, Salive ME. Disability as a public health outcome in the aging population. Annu Rev Public Health 1996;17:25-46
  6. Fries JF. Measuring and monitoring success in compressing morbidity. Ann Intern Med 2003;139: 455-459
  7. Ryan DH, Espeland MA, Foster GD, et al.; Look AHEAD Research Group. Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials 2003;24:610-628
  8. Wadden TA, West DS, Delahanty L, et al.; Look AHEAD Research Group. The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it. Obesity (Silver Spring) 2006;14:737-752
  9. Wesche-Thobaben JA. The development and description of the comparison group in the Look AHEAD trial. Clin Trials 2011;8:320-329
  10. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30:473-483
  11. Ip EH, Zhang Q, Rejeski WJ, Harris TB, Kritchevsky S. Partially ordered mixed hidden Markov model for the disablement process of older adults. J Am Stat Assoc 2013;108:370-380
  12. Zhang EH, Rijmen F, Ip EH. Multivariate dis- crete hidden Markov models for domain-based measurements and assessment of risk factors in child development. J Graph Comput Stat 2010;19: 746-765
  13. Ross S. Introduction to Probability Models. Oxford, UK, Academic Press, 2014
  14. Bianchi L, Zuliani G, Volpato S. Physical dis- ability in the elderly with diabetes: epidemiology and mechanisms. Curr Diab Rep 2013;13:824-830
  15. Volpato S, Ferrucci L, Blaum C, et al. Progres- sion of lower-extremity disability in older women with diabetes: the Women's Health and Aging Study. Diabetes Care 2003;26:70-75
  16. Messier SP, Loeser RF, Miller GD, et al. Exer- cise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum 2004;50:1501-1510
  17. Ettinger WH Jr, Burns R, Messier SP, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education pro- gram in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997;277:25-31
  18. Jakicic JM, Egan CM, Fabricatore AN, et al.; Look AHEAD Research Group. Four-year change in cardiorespiratory fitness and influence on glyce- mic control in adults with type 2 diabetes in a randomized trial: the Look AHEAD Trial. Diabetes Care 2013;36:1297-1303
  19. Zhang P, Hire D, Espeland MA, et al.; Look AHEAD Research Group. Impact of intensive life- style intervention on preference-based quality of life in type 2 diabetes: results from the Look AHEAD trial. Obesity (Silver Spring) 2016;24:856-864
  20. Rubin RR, Wadden TA, Bahnson JL, et al.; Look AHEAD Research Group. Impact of intensive life- style intervention on depression and health- related quality of life in type 2 diabetes: the Look AHEAD trial. Diabetes Care 2014;37:1544-1553

Cited by

Sorted by citations

Authors
Gregg, E. W., Lin, J., Bardenheier, B., Chen, H., Rejeski, W. J., Zhuo, X., Hergenroeder, A. L., Kritchevsky, S. B., Peters, A. L., Wagenknecht, L. E., Ip, E. H., Espeland, M. A., & for the Look AHEAD Study Group
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Wake Forest University Health Sciences (US)
  • Wake Forest University (US)
  • Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
  • University of Pittsburgh (US)
  • University of Southern California (US)
Corresponding author
Gregg, Edward W.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2018-03-15
Volume
41
Issue
5
Pages
1040-1048
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc17-2110
PMC
PMC5911793
OpenAlex
W2794396820
Cited by
64
References
5
Citations by year
2026: 4 · 2025: 5 · 2024: 11 · 2023: 6 · 2022: 8 · 2021: 9 · 2020: 11 · 2019: 5 · 2018: 4 · 2017: 1
FWCI
5.77
Type
journal article
Language
en
Open access
Licence
www.diabetesjournals.org/content/license (vor, 36 d)
Locations
  • Diabetes Care (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Spiral (Imperial College London) (submittedVersion)
Funders
National Institutes of Health
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
intensive lifestyle intervention, type 2 diabetes, physical disability, disability-free life expectancy, weight loss, obesity, diabetes support and education, physical function, cardiovascular disease
MeSH terms
Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Persons with Disabilities, Disabled Persons, Health Education, Humans, Life Expectancy, Life Style, Male, Middle Aged, Obesity, Weight Loss, Incidence, Risk Reduction Behavior, Diabetes Complications, Overweight

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review