Long-term Change in Physiological Markers and Cognitive Performance in Type 2 Diabetes: The Look AHEAD Study
Year: 2020
Type: article
Abstract: CONTEXT: The effects of physiological improvements on cognitive function among persons with type 2 diabetes mellitus (T2DM) are not fully understood. OBJECTIVE: To determine whether improvements in physiological markers (body weight, blood sugar control, and physical activity) during intensive lifestyle intervention (ILI) are associated with enhancements in cognitive function in older adults with T2DM. DESIGN: Multisite randomized controlled trial. SETTING: Academic research centers. PATIENTS OR OTHER PARTICIPANTS: Participants were aged 45-76 years, with T2DM. INTERVENTION: The Action for Health in Diabetes (Look AHEAD) study, a randomized, controlled clinical trial of ILI. MAIN OUTCOME MEASURE: Two to 3 cognitive assessments were collected from 1089 participants, the first and last occurring a mean (standard deviation) of 8.6 (1.0) and 11.5 (0.7) years after enrollment. RESULTS: Greater improvement in blood sugar control was associated with better cognitive scores (fasting glucose and Rey Auditory Verbal Learning Test [AVLT]: P = 0.0148; fasting glucose and Digit Symbol Coding (DSC): P = 0.0360; HbA1C and DSC: P = 0.0477); but weight loss had mixed associations with cognitive scores (greater body mass index [BMI] reduction and worse AVLT overall: P = 0.0053; and greater BMI reduction and better DSC scores among those overweight but not obese at baseline: P = 0.010). Associations were strongest among those who were overweight (not obese) at baseline, and among those with a history of cardiovascular disease (CVD) at baseline. CONCLUSIONS: Improvements in glycemic control, but not necessarily weight status, during ILI may be associated with better subsequent cognitive performance. These associations may differ by adiposity and CVD history.
Institutions: Pennington Biomedical Research Center, Wake Forest University Health Sciences, Wake Forest University, University of Alabama at Birmingham, Joslin Diabetes Center, Harvard University, Columbia University Irving Medical Center, Columbia University, University of Tennessee Health Science Center, Johns Hopkins University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Veterans Affairs, Harvard Catalyst, National Institutes of Health, Centers for Disease Control and Prevention, Center for Clinical and Translational Research, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Center on Minority Health and Health Disparities, National Center for Research Resources, Office of Research on Women's Health
Awards: G1149464818, G1153163889, G1681235271, G1825392443, Wake Forest Alzheimer's Disease Core Center, G1895210975, G1902398179, G2017939603, G241913450, G2456504948, G2469879864, General Clinical Research Center, G2875079641, Action for Health in Diabetes Continuation (Look AHEAD-E), G3041424743, 05/16 Action for Health in Diabetes Extension Study - Research Project, 10/16 Action for Health in Diabetes Extension Study Research Project, General Clinical Research Center, 14/16 Action for Health in Diabetes Extension Study Research Project, 02/16 Action for Health in Diabetes Extension Study Research Study, Harvard Clinical and Translational Science Center (UL1), General Clinical Research Center, General Clinical Research Center, GENERAL CLINICAL RESEARCH CENTER, University of Pittsburgh Clinical and Translational Science Institute, G4140582021, 16/16 Action for Health in Diabetes Extension Study Biostatistics Research Center, G4451789618, G5085995034, 09/16 Action for Health in Diabetes Extension Study Research Project, 08/16 Action for Health in Diabetes Extension Study Research Project, 07/16 Action for Health in Diabetes Extension Study Research Project, G6216466123, 04/16 Action for Health in Diabetes Extension Study Research Project, 03/16 Action for Health in Diabetes Extension Study Research Project, 13/16 Action for Health in Diabetes Extension Study Research Project, G677419319, 11/16 Action for Health in Diabetes Extension Study Research Project, 15/16 Action for Health in Diabetes Extension Study Research Project, Obesity/Nutrition Research Center, 12/16 Action for Health in Diabetes Extension Study Research Project, 06/16 Action for Health in Diabetes Extension Study Research Project, G9000113229, Colorado Nutrition Obesity Research Center, UAB Nutrition Obesity Research Center (NORC), UAB Diabetes Research Center, G900410922, G955307958
OpenAlex ID: W3080267588