Felicia R Simpson1, Owen Carmichael2, Kathleen M Hayden3, Christina E Hugenschmidt4, Jeanne M McCaffery5, Sevil Yasar6, Nicholas M Pajewski7, Mark A Espeland8. 1. Department of Mathematics, Winston-Salem State University, 601 S. Martin Luther King Jr. Drive, Winston-Salem, NC 27110, United States of America. 2. Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States of America. 3. Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, NC 27101, United States of America. 4. Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America. 5. Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, United States of America. 6. Departrment of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21224, United States of America. 7. Department of Biostatistics and Data Science, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America. 8. Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America; Department of Biostatistics and Data Science, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America. Electronic address: mespelan@wakehealth.edu.
Abstract
AIMS: To assess whether there is an opportune window when intensive lifestyle intervention (ILI) benefits cognitive function. METHODS: Standardized cognitive assessments were collected following ≥8 years of either ILI or a control condition of diabetes support and education (DSE) in 3708 individuals, ages 45-76 years at enrollment, with type 2 diabetes and overweight or obesity. Frailty index (FI) scores were used to group individuals at baseline into tertiles according to their age-related health status. Linear models were used to describe intervention adherence and cognitive function, with interaction terms to examine the consistency of relationships among tertiles. RESULTS: Worse baseline FI scores were associated with poorer subsequent performance in tests of attention, processing speed, and executive function. No differences in any measure of cognitive function were observed between intervention groups within any FI tertile (all p > 0.10). Among individuals with worse baseline FI scores, weight gain was associated with poorer global cognitive function among participants assigned to DSE. There was no association between weight changes and cognitive function among participants assigned to ILI. CONCLUSIONS: Among adults with type 2 diabetes and overweight/obesity, we found no evidence that there is a window of opportunity based on FI when ILI benefits cognitive function.
AIMS: To assess whether there is an opportune window when intensive lifestyle intervention (ILI) benefits cognitive function. METHODS: Standardized cognitive assessments were collected following ≥8 years of either ILI or a control condition of diabetes support and education (DSE) in 3708 individuals, ages 45-76 years at enrollment, with type 2 diabetes and overweight or obesity. Frailty index (FI) scores were used to group individuals at baseline into tertiles according to their age-related health status. Linear models were used to describe intervention adherence and cognitive function, with interaction terms to examine the consistency of relationships among tertiles. RESULTS: Worse baseline FI scores were associated with poorer subsequent performance in tests of attention, processing speed, and executive function. No differences in any measure of cognitive function were observed between intervention groups within any FI tertile (all p > 0.10). Among individuals with worse baseline FI scores, weight gain was associated with poorer global cognitive function among participants assigned to DSE. There was no association between weight changes and cognitive function among participants assigned to ILI. CONCLUSIONS: Among adults with type 2 diabetes and overweight/obesity, we found no evidence that there is a window of opportunity based on FI when ILI benefits cognitive function.
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