A long-term intensive lifestyle intervention and physical function: the look AHEAD Movement and Memory Study

Area of Science:

• Gerontology and Geriatric Medicine
• Metabolic and Endocrine Disorders
• Physical Therapy and Rehabilitation

Background:

• Obesity and type 2 diabetes are prevalent in middle-aged and older adults.
• Physical function decline is common in this demographic, impacting quality of life.
• Lifestyle interventions aim to manage weight and improve health outcomes.

Purpose of the Study:

• To evaluate the long-term effects of an intensive lifestyle intervention (ILI) on physical function.
• To compare ILI with diabetes support and education (DSE) in overweight/obese adults with type 2 diabetes.
• To assess physical function 8 years post-randomization in the Look AHEAD trial.

Main Methods:

• Randomized post-test design involving 964 overweight/obese adults (45-76 years) with type 2 diabetes.
• Intervention groups: ILI (weight loss via diet and exercise) vs. DSE (standard care).
• Physical function assessed using SPPBexp, 20-m and 400-m walk tests, and strength measures at 8 years.

Main Results:

• ILI group showed significantly better SPPBexp scores and faster walk speeds compared to DSE at 8 years.
• Weight loss achieved through ILI partially explained the improvements in physical function.
• However, the intervention's effect on physical function was no longer statistically significant after accounting for weight loss.

Conclusions:

• An intensive lifestyle intervention demonstrates long-term benefits for mobility function in overweight and obese middle-aged and older individuals with type 2 diabetes.
• Weight loss achieved through lifestyle modification is a key mediator of improved physical function.
• Sustained lifestyle changes are crucial for maintaining physical function in this population.