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- Title
Physical Function Following a Long-Term Lifestyle Intervention Among Middle Aged and Older Adults With Type 2 Diabetes: The Look AHEAD Study.
- Authors
Houston, Denise K; Neiberg, Rebecca H; Miller, Michael E; Hill, James O; Jakicic, John M; Johnson, Karen C; Gregg, Edward W; Hubbard, Van S; Pi-Sunyer, Xavier; Rejeski, W Jack; Wing, Rena R; Bantle, John P; Beale, Elizabeth; Berkowitz, Robert I; Cassidy-Begay, Maria; Clark, Jeanne M; Coday, Mace; Delahanty, Linda M; Dutton, Gareth; Egan, Caitlin
- Abstract
<bold>Background: </bold>Lifestyle interventions have been shown to improve physical function over the short term; however, whether these benefits are sustainable is unknown. The long-term effects of an intensive lifestyle intervention (ILI) on physical function were assessed using a randomized post-test design in the Look AHEAD trial.<bold>Methods: </bold>Overweight and obese (body mass index ≥ 25 kg/m2) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes enrolled in Look AHEAD, a trial evaluating an ILI designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including a 4- and 400-m walk, lower extremity physical performance (expanded Short Physical Performance Battery, SPPBexp), and grip strength approximately 11 years postrandomization and 1.5 years after the intervention was stopped (n = 3,783).<bold>Results: </bold>Individuals randomized to ILI had lower odds of slow gait speed (<0.8 m/s) compared to those randomized to DSE (adjusted OR [95% CI]: 0.84 [0.71 to 0.99]). Individuals randomized to ILI also had faster gait speed over 4- and 400-m (adjusted mean difference [95% CI]: 0.019 [0.007 to 0.031] m/s, p = .002, and 0.023 [0.012 to 0.034] m/sec, p < .0001, respectively) and higher SPPBexp scores (0.037 [0.011 to 0.063], p = .005) compared to those randomized to DSE. The intervention effect was slightly larger for SPPBexp scores among older versus younger participants (0.081 [0.038 to 0.124] vs 0.013 [-0.021 to 0.047], p = .01).<bold>Conclusions: </bold>An intensive lifestyle intervention has modest but significant long-term benefits on physical function in overweight and obese middle-aged and older adults with type 2 diabetes.<bold>Clinicaltrials.gov Identifier: </bold>NCT00017953.
- Subjects
TYPE 2 diabetes; OLDER people physiology; MIDDLE age; OVERWEIGHT persons; BODY mass index; LIFESTYLES &; health; PHYSIOLOGY
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2018, Vol 73, Issue 11, p1552
- ISSN
1079-5006
- Publication type
journal article
- DOI
10.1093/gerona/glx204