Long-term impact of behavioral weight loss intervention on cognitive function

Mark A. Espeland, Stephen R. Rapp, George A. Bray, Denise K. Houston, Karen Johnson, Abbas E. Kitabchi, Andrea L. Hergenroeder, Jeff Williamson, John M. Jakicic, Brent Van Dorsten, Stephen B. Kritchevsky

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background. It is unknown whether intentional weight loss provides long-term benefits for cognitive function. Methods. An ancillary study to a randomized controlled clinical trial was conducted in overweight and obese individuals (N = 978), aged 45-76 years at enrollment, with type 2 diabetes. An intensive behavioral intervention designed to promote and maintain weight loss through caloric restriction and increased physical activity was compared with diabetes support and education. Standardized assessments of cognitive function were collected an average of 8.1 years after trial enrollment. Results. Participants assigned to intensive lifestyle intervention lost a mean (SE) 11.1% (0.4%) and 7.2% (0.5%) of weight at Years 1 and 8, respectively, compared with 1.0% (0.2%) and 3.3% (0.5%) in the control group (p <. 001). Covariate-adjusted mean composite cognitive function test scores were similar for the two groups (p =. 69), and no significant differences were found for any individual cognitive test. There was some evidence of a differential effect (nominal interaction p =. 008) for a prespecified comparison: Intensive lifestyle intervention was associated with a relative mean benefit for composite cognitive function of 0.276 (95% confidence interval: 0.033, 0.520) SDs among individuals with body mass index less than 30kg/m2 at baseline compared with a relative mean deficit of 0.086 (-0.021, 0.194) SDs among individuals with body mass more than or equal to 30kg/m2. Conclusions. Eight years of intensive lifestyle intervention did not alter cognitive function in obese adults with type 2 diabetes; however, there was evidence for benefit among overweight but not obese individuals. Changes in cognition were not assessed in this cross-sectional study.

Original languageEnglish (US)
Pages (from-to)1101-1108
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume69
Issue number9
DOIs
StatePublished - Jan 1 2014

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Cognition
Weight Loss
Life Style
Type 2 Diabetes Mellitus
Caloric Restriction
Body Mass Index
Randomized Controlled Trials
Cross-Sectional Studies
Confidence Intervals
Exercise
Education
Weights and Measures
Control Groups

All Science Journal Classification (ASJC) codes

  • Aging
  • Geriatrics and Gerontology

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Long-term impact of behavioral weight loss intervention on cognitive function. / Espeland, Mark A.; Rapp, Stephen R.; Bray, George A.; Houston, Denise K.; Johnson, Karen; Kitabchi, Abbas E.; Hergenroeder, Andrea L.; Williamson, Jeff; Jakicic, John M.; Van Dorsten, Brent; Kritchevsky, Stephen B.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 69, No. 9, 01.01.2014, p. 1101-1108.

Research output: Contribution to journalArticle

Espeland, MA, Rapp, SR, Bray, GA, Houston, DK, Johnson, K, Kitabchi, AE, Hergenroeder, AL, Williamson, J, Jakicic, JM, Van Dorsten, B & Kritchevsky, SB 2014, 'Long-term impact of behavioral weight loss intervention on cognitive function', Journals of Gerontology - Series A Biological Sciences and Medical Sciences, vol. 69, no. 9, pp. 1101-1108. https://doi.org/10.1093/gerona/glu031
Espeland, Mark A. ; Rapp, Stephen R. ; Bray, George A. ; Houston, Denise K. ; Johnson, Karen ; Kitabchi, Abbas E. ; Hergenroeder, Andrea L. ; Williamson, Jeff ; Jakicic, John M. ; Van Dorsten, Brent ; Kritchevsky, Stephen B. / Long-term impact of behavioral weight loss intervention on cognitive function. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2014 ; Vol. 69, No. 9. pp. 1101-1108.
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AU - Espeland, Mark A.

AU - Rapp, Stephen R.

AU - Bray, George A.

AU - Houston, Denise K.

AU - Johnson, Karen

AU - Kitabchi, Abbas E.

AU - Hergenroeder, Andrea L.

AU - Williamson, Jeff

AU - Jakicic, John M.

AU - Van Dorsten, Brent

AU - Kritchevsky, Stephen B.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background. It is unknown whether intentional weight loss provides long-term benefits for cognitive function. Methods. An ancillary study to a randomized controlled clinical trial was conducted in overweight and obese individuals (N = 978), aged 45-76 years at enrollment, with type 2 diabetes. An intensive behavioral intervention designed to promote and maintain weight loss through caloric restriction and increased physical activity was compared with diabetes support and education. Standardized assessments of cognitive function were collected an average of 8.1 years after trial enrollment. Results. Participants assigned to intensive lifestyle intervention lost a mean (SE) 11.1% (0.4%) and 7.2% (0.5%) of weight at Years 1 and 8, respectively, compared with 1.0% (0.2%) and 3.3% (0.5%) in the control group (p <. 001). Covariate-adjusted mean composite cognitive function test scores were similar for the two groups (p =. 69), and no significant differences were found for any individual cognitive test. There was some evidence of a differential effect (nominal interaction p =. 008) for a prespecified comparison: Intensive lifestyle intervention was associated with a relative mean benefit for composite cognitive function of 0.276 (95% confidence interval: 0.033, 0.520) SDs among individuals with body mass index less than 30kg/m2 at baseline compared with a relative mean deficit of 0.086 (-0.021, 0.194) SDs among individuals with body mass more than or equal to 30kg/m2. Conclusions. Eight years of intensive lifestyle intervention did not alter cognitive function in obese adults with type 2 diabetes; however, there was evidence for benefit among overweight but not obese individuals. Changes in cognition were not assessed in this cross-sectional study.

AB - Background. It is unknown whether intentional weight loss provides long-term benefits for cognitive function. Methods. An ancillary study to a randomized controlled clinical trial was conducted in overweight and obese individuals (N = 978), aged 45-76 years at enrollment, with type 2 diabetes. An intensive behavioral intervention designed to promote and maintain weight loss through caloric restriction and increased physical activity was compared with diabetes support and education. Standardized assessments of cognitive function were collected an average of 8.1 years after trial enrollment. Results. Participants assigned to intensive lifestyle intervention lost a mean (SE) 11.1% (0.4%) and 7.2% (0.5%) of weight at Years 1 and 8, respectively, compared with 1.0% (0.2%) and 3.3% (0.5%) in the control group (p <. 001). Covariate-adjusted mean composite cognitive function test scores were similar for the two groups (p =. 69), and no significant differences were found for any individual cognitive test. There was some evidence of a differential effect (nominal interaction p =. 008) for a prespecified comparison: Intensive lifestyle intervention was associated with a relative mean benefit for composite cognitive function of 0.276 (95% confidence interval: 0.033, 0.520) SDs among individuals with body mass index less than 30kg/m2 at baseline compared with a relative mean deficit of 0.086 (-0.021, 0.194) SDs among individuals with body mass more than or equal to 30kg/m2. Conclusions. Eight years of intensive lifestyle intervention did not alter cognitive function in obese adults with type 2 diabetes; however, there was evidence for benefit among overweight but not obese individuals. Changes in cognition were not assessed in this cross-sectional study.

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