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- Title
Impact of Multidomain Lifestyle Intervention on Frailty Through the Lens of Deficit Accumulation in Adults with Type 2 Diabetes Mellitus.
- Authors
Simpson, Felicia R; Pajewski, Nicholas M; Nicklas, Barbara; Kritchevsky, Stephen; Bertoni, Alain; Ingram, Frank; Ojeranti, Daniel; Espeland, Mark A; Trial, for the Indices for Accelerated Aging in Obesity and Diabetes Ancillary Study of the Action for Health in Diabetes (Look AHEAD); Indices for Accelerated Aging in Obesity and Diabetes Ancillary Study of the Action for Health in Diabetes (Look AHEAD) Trial
- Abstract
<bold>Background: </bold>Type 2 diabetes and obesity increase the accumulation of health deficits and may accelerate biological aging. Multidomain lifestyle interventions may mitigate against this.<bold>Methods: </bold>Within a large, randomized clinical trial of intensive lifestyle intervention including caloric restriction, increased physical activity, dietary counseling, and risk factor monitoring compared with diabetes support and education, we examined the accumulation of health deficits across 8 years. We used two complementary frailty indices (FIs) based on deficit accumulation, one modeled on work in the Systolic Blood Pressure Intervention Trial and the other including additional deficits related to obesity and type 2 diabetes mellitus. Differences between intervention groups and their consistency among subgroups were assessed with re-randomization tests.<bold>Results: </bold>Data from 4,859 adults (45-76 years at baseline, 59% female) were analyzed. Random assignment to intensive lifestyle intervention was associated with lower FI scores throughout follow-up as captured by areas under curves traced by longitudinal means (p ≤ .001), over which time mean (SE) differences between intervention groups averaged 5.8% (0.9%) and 5.4% (0.9%) for the two indices. At year 8, the percentage of participants classified as frail (FI > 0.21) was lower among intensive lifestyle intervention (39.8% and 54.5%) compared with diabetes support and education (42.7% and 60.9%) for both FIs (both p < .001). Intervention benefits were relatively greater for participants who were older, not obese, and without history of cardiovascular disease at baseline.<bold>Conclusions: </bold>Eight years of multidomain lifestyle intervention create a buffer against the accumulation of age-related health deficits in overweight or obese adults with type 2 diabetes.ClinicalTrials.gov Identifier: NCT00017953.
- Subjects
TYPE 2 diabetes; OBESITY; SYSTOLIC blood pressure; NUTRITION counseling; CARDIOVASCULAR diseases; LOW-calorie diet
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2020, Vol 75, Issue 10, p1921
- ISSN
1079-5006
- Publication type
journal article
- DOI
10.1093/gerona/glz197