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J Am Geriatr Soc. 2017 Jan 9. doi: 10.1111/jgs.14692. [Epub ahead of print]

Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study.

Author information

  • 1Department of Psychiatry and Behavioral Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
  • 2Department of Medicine, Columbia University Medical Center, New York, New York.
  • 3Department of Epidemiology, Columbia University Medical Center, New York, New York.
  • 4Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
  • 5Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Division of Nutrition, Harvard Medical School, Boston, Massachusetts.
  • 6Department of Medicine, University of Texas Health Sciences Center, San Antonio, Texas.
  • 7Department of Psychiatry and Human Behavior, Miriam Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island.
  • 8Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
  • 9Pennington Biomedical Research Center, Baton Rouge, Louisiana.
  • 10Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
  • 11Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
  • 12Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
  • 13Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charleston, Massachusetts.



To assess whether randomization to 10 years of lifestyle intervention to induce and maintain weight loss improves cognitive function.


Randomized controlled clinical trial.


Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Continuation study (U01 DK057136-15).


Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 (N = 3,751).


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).


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.


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).


A long-term behavioral weight loss intervention for overweight and obese adults with diabetes mellitus was not associated with cognitive benefit. Trial Registration Identifier: NCT00017953.


cognition; diabetes mellitus; intervention; obesity; weight loss

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