Cargando…

Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study

INTRODUCTION: This study sought to determine whether 10 years of assignment to intensive lifestyle intervention (ILI) relative to diabetes support and education leads to better cognition. We examine intervention effects overall and among clinical subgroups, and report correlations between computer-a...

Descripción completa

Detalles Bibliográficos
Autores principales: Hayden, Kathleen M., Baker, Laura D., Bray, George, Carvajal, Raymond, Demos-McDermott, Kathryn, Hergenroeder, Andrea L., Hill, James O., Horton, Edward, Jakicic, John M., Johnson, Karen C., Neiberg, Rebecca H., Rapp, Stephen R., Wadden, Thomas A., Miller, Michael E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675717/
https://www.ncbi.nlm.nih.gov/pubmed/29159267
http://dx.doi.org/10.1016/j.dadm.2017.09.002
_version_ 1783276962819604480
author Hayden, Kathleen M.
Baker, Laura D.
Bray, George
Carvajal, Raymond
Demos-McDermott, Kathryn
Hergenroeder, Andrea L.
Hill, James O.
Horton, Edward
Jakicic, John M.
Johnson, Karen C.
Neiberg, Rebecca H.
Rapp, Stephen R.
Wadden, Thomas A.
Miller, Michael E.
author_facet Hayden, Kathleen M.
Baker, Laura D.
Bray, George
Carvajal, Raymond
Demos-McDermott, Kathryn
Hergenroeder, Andrea L.
Hill, James O.
Horton, Edward
Jakicic, John M.
Johnson, Karen C.
Neiberg, Rebecca H.
Rapp, Stephen R.
Wadden, Thomas A.
Miller, Michael E.
author_sort Hayden, Kathleen M.
collection PubMed
description INTRODUCTION: This study sought to determine whether 10 years of assignment to intensive lifestyle intervention (ILI) relative to diabetes support and education leads to better cognition. We examine intervention effects overall and among clinical subgroups, and report correlations between computer-administered and interviewer-administered cognitive batteries. METHODS: The Action for Health in Diabetes (Look AHEAD) was a 16-site randomized controlled trial with overweight/obese individuals (aged 45–76) who had type 2 diabetes. The NIH Toolbox Cognition Battery tests developed to measure cognition across the lifespan were used to evaluate cognition. Results were compared with standard paper-and-pencil tests. The Toolbox and paper-and-pencil tests were administered an average of 10.9 years after randomization to 1002 participants. RESULTS: Toolbox measures significantly correlated with interviewer-administered measures, with the strongest correlations between the Toolbox Fluid Cognition Composite and Trails B (r = −0.64, P < .0001) and Digit Symbol Coding (r = 0.63, P < .0001), and between the Toolbox Dimensional Change Card Sort (r = 0.55, P < .0001) and the Digit Symbol Coding test. Overall, ILI and diabetes support and education groups had similar adjusted mean cognitive outcomes (P > .05 for all). Subgroup analyses identified different intervention effects within baseline body mass index groups for Picture Sequence Memory (P = .01), within baseline cardiovascular disease groups for Picture Vocabulary (P = .01) and Fluid Cognition Composite (P = .02) measures, and within baseline age groups for Picture Vocabulary (P = .02). DISCUSSION: Correlations between Toolbox and interviewer-administered outcomes provide a measure of internal validity. Findings suggest no overall effect of the intervention on cognition and that an ILI resulting in weight loss may have negative implications for cognition in individuals aged ≥60, with previous history of cardiovascular disease, and those with body mass index ≥40.
format Online
Article
Text
id pubmed-5675717
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-56757172017-11-20 Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study Hayden, Kathleen M. Baker, Laura D. Bray, George Carvajal, Raymond Demos-McDermott, Kathryn Hergenroeder, Andrea L. Hill, James O. Horton, Edward Jakicic, John M. Johnson, Karen C. Neiberg, Rebecca H. Rapp, Stephen R. Wadden, Thomas A. Miller, Michael E. Alzheimers Dement (Amst) Cognitive & Behavioral Assessment INTRODUCTION: This study sought to determine whether 10 years of assignment to intensive lifestyle intervention (ILI) relative to diabetes support and education leads to better cognition. We examine intervention effects overall and among clinical subgroups, and report correlations between computer-administered and interviewer-administered cognitive batteries. METHODS: The Action for Health in Diabetes (Look AHEAD) was a 16-site randomized controlled trial with overweight/obese individuals (aged 45–76) who had type 2 diabetes. The NIH Toolbox Cognition Battery tests developed to measure cognition across the lifespan were used to evaluate cognition. Results were compared with standard paper-and-pencil tests. The Toolbox and paper-and-pencil tests were administered an average of 10.9 years after randomization to 1002 participants. RESULTS: Toolbox measures significantly correlated with interviewer-administered measures, with the strongest correlations between the Toolbox Fluid Cognition Composite and Trails B (r = −0.64, P < .0001) and Digit Symbol Coding (r = 0.63, P < .0001), and between the Toolbox Dimensional Change Card Sort (r = 0.55, P < .0001) and the Digit Symbol Coding test. Overall, ILI and diabetes support and education groups had similar adjusted mean cognitive outcomes (P > .05 for all). Subgroup analyses identified different intervention effects within baseline body mass index groups for Picture Sequence Memory (P = .01), within baseline cardiovascular disease groups for Picture Vocabulary (P = .01) and Fluid Cognition Composite (P = .02) measures, and within baseline age groups for Picture Vocabulary (P = .02). DISCUSSION: Correlations between Toolbox and interviewer-administered outcomes provide a measure of internal validity. Findings suggest no overall effect of the intervention on cognition and that an ILI resulting in weight loss may have negative implications for cognition in individuals aged ≥60, with previous history of cardiovascular disease, and those with body mass index ≥40. Elsevier 2017-10-09 /pmc/articles/PMC5675717/ /pubmed/29159267 http://dx.doi.org/10.1016/j.dadm.2017.09.002 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Cognitive & Behavioral Assessment
Hayden, Kathleen M.
Baker, Laura D.
Bray, George
Carvajal, Raymond
Demos-McDermott, Kathryn
Hergenroeder, Andrea L.
Hill, James O.
Horton, Edward
Jakicic, John M.
Johnson, Karen C.
Neiberg, Rebecca H.
Rapp, Stephen R.
Wadden, Thomas A.
Miller, Michael E.
Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study
title Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study
title_full Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study
title_fullStr Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study
title_full_unstemmed Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study
title_short Long-term impact of intensive lifestyle intervention on cognitive function assessed with the National Institutes of Health Toolbox: The Look AHEAD study
title_sort long-term impact of intensive lifestyle intervention on cognitive function assessed with the national institutes of health toolbox: the look ahead study
topic Cognitive & Behavioral Assessment
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675717/
https://www.ncbi.nlm.nih.gov/pubmed/29159267
http://dx.doi.org/10.1016/j.dadm.2017.09.002
work_keys_str_mv AT haydenkathleenm longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT bakerlaurad longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT braygeorge longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT carvajalraymond longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT demosmcdermottkathryn longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT hergenroederandreal longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT hilljameso longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT hortonedward longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT jakicicjohnm longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT johnsonkarenc longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT neibergrebeccah longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT rappstephenr longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT waddenthomasa longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy
AT millermichaele longtermimpactofintensivelifestyleinterventiononcognitivefunctionassessedwiththenationalinstitutesofhealthtoolboxthelookaheadstudy