title: Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study.
abstract: OBJECTIVE
  To assess whether randomization to 10 years of lifestyle intervention to induce and maintain weight loss improves cognitive function.
  
  
  METHODS
  Randomized controlled clinical trial.
  
  
  METHODS
  Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Continuation study (U01 DK057136-15).
  
  
  METHODS
  Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 (N = 3,751).
  
  
  METHODS
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  A long-term behavioral weight loss intervention for overweight and obese adults with diabetes mellitus was not associated with cognitive benefit. Trial Registration clinicaltrials.gov Identifier: NCT00017953.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Rapp
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, New York.|Department of Epidemiology, Columbia University Medical Center, New York, New York.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Luchsinger
authors.affiliation: Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Baker
authors.affiliation: Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Division of Nutrition, Harvard Medical School, Boston, Massachusetts.
authors.forename: George L
authors.initials: GL
authors.lastname: Blackburn
authors.affiliation: Department of Medicine, University of Texas Health Sciences Center, San Antonio, Texas.
authors.forename: Helen P
authors.initials: HP
authors.lastname: Hazuda
authors.affiliation: Department of Psychiatry and Human Behavior, Miriam Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Demos-McDermott
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Jeffery
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, Louisiana.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Keller
authors.affiliation: Department of Psychiatry and Human Behavior, Miriam Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: McCaffery
authors.affiliation: Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Pajewski
authors.affiliation: Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
authors.forename: Mary
authors.initials: M
authors.lastname: Evans
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.affiliation: Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charleston, Massachusetts.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Arnold
authors.affiliation: Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
mesh_terms: D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000534:rehabilitation; D010353:Patient Education as Topic / Q000379:methods; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
keywords: cognition; diabetes mellitus; intervention; obesity; weight loss