title: Aging and physical function in type 2 diabetes: 8 years of an intensive lifestyle intervention.
abstract: BACKGROUND
  Compared with adults without type 2 diabetes mellitus, those with the disease experience more limitations in their physical functioning (PF). Look AHEAD is a large multicenter trial that examined the effects of an intensive lifestyle intervention (ILI) for weight loss on cardiovascular outcomes compared with diabetes support and education (DSE). Although the current study compared treatment differences between ILI and DSE on PF, the primary goal was to examine whether this effect was moderated by age and history of cardiovascular disease at enrollment.
  
  
  METHODS
  Overweight or obese adults with type 2 diabetes mellitus (n = 5,145) were randomly assigned to either ILI or DSE. The mean (±SD) age and % females in ILI was 58.9 years (±6.9) and 59.8%; it was 58.6 years (6.8) and 59.5% in DSE. Analysis in 4,998 participants assessed the differential rates of decline in PF across a period of 8 years for the ILI and DSE groups.
  
  
  RESULTS
  ILI resulted in improved PF compared with DSE after 1 year (p < .0001) and was maintained across time. Within the ILI, older adults experienced greater improvements than younger adults (p < .0001). By year 2, persons in ILI with preexisting cardiovascular disease were no different in PF than in DSE participants with preexisting cardiovascular disease.
  
  
  CONCLUSIONS
  With the exception of persons who had a history of cardiovascular disease, ILI slowed the decline in PF with type 2 diabetes mellitus despite weight regain, an effect that was stronger for older than younger participants and could translate into reductions in falls and disability.
authors.affiliation: Department of Health and Exercise Science, Wake Forest University, Reynolda Campus, Winston-Salem, North Carolina. rejeski@wfu.edu.
authors.forename: W Jack
authors.initials: WJ
authors.lastname: Rejeski
authors.affiliation: Pennington Biomedical Research Center/LSU, Baton Rouge, Louisiana.
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: Shyh-Huei
authors.initials: SH
authors.lastname: Chen
authors.affiliation: Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Clark
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
authors.forename: Mary
authors.initials: M
authors.lastname: Evans
authors.affiliation: Department of Pediatrics and Medicine, University of Colorado School of Medicine, Denver.
authors.forename: James O
authors.initials: JO
authors.lastname: Hill
authors.affiliation: Department of Health and Physical Activity, University of Pittsburgh, Pennsylvania.
authors.forename: John M
authors.initials: JM
authors.lastname: Jakicic
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Neiberg
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: Edward H
authors.initials: EH
authors.lastname: Ip
mesh_terms: D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology* / Q000517:prevention & control; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D015431:Weight Loss
keywords: Diabetes; Functional performance.; Obesity