Effects of Intensive Lifestyle Intervention on All-Cause Mortality in Older Adults With Type 2 Diabetes and Overweight/Obesity: Results From the Look AHEAD Study
Year: 2022
Type: other
Abstract: Background. Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) and diabetes support and education (DSE) (control) in 5145 individuals with overweight/obesity and type 2 diabetes, found no significant differences in all-cause or cardiovascular mortality or morbidity during 9.6 (median) years of intervention. Participants in ILI who lost ≥10% at 1 year had lower risk of composite cardiovascular outcomes relative to DSE. Objective: Since effects of ILI may take many years to emerge, we conducted intent-to-treat analyses comparing mortality in ILI over 16.7 years (9.6 year of intervention and then observation) to DSE. In a secondary exploratory analysis, we compared mortality by magnitude of weight loss in ILI relative to DSE. Methods. Primary outcome was all-cause mortality from randomization to 16.7 years. Other outcomes included cause-specific mortality, interactions by sub-groups (age, sex, race/ethnicity, CVD history) and an exploratory analysis by magnitude of weight loss in ILI vs DSE as reference. Analyses used proportional hazards regression and likelihood ratio. Results. The incidence of all-cause mortality did not differ significantly in ILI and DSE (549 and 589 participants respectively); HR = 0.91; 95% CI (0.81,1.02), p=0.11. There were no significant differences between treatments in cause-specific mortality or within prespecified subgroups. ILI participants who lost ≥10% at 1 year had a 21% reduced risk of mortality (HR=0.79, CI 0.67,0.94, p=0.007) relative to DSE. Conclusions. ILI focused on weight loss did not significantly affect mortality risk. However, ILI participants who lost ≥10% had reduced mortality relative to DSE.
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Funders: U.S. Department of Veterans Affairs, LifeScan, New York City Department of Health and Mental Hygiene, Massachusetts General Hospital, University of Southern California, Massachusetts Institute of Technology, Wake Forest University, University of Minnesota, Harvard Catalyst, University of Washington, Joslin Diabetes Center, Johns Hopkins University, University of Pittsburgh, Deutsches Krebsforschungszentrum, National Institutes of Health, Centers for Disease Control and Prevention, Health Science Center, University of Tennessee, University of Texas Health Science Center at San Antonio, Anschutz Medical Campus, University of Colorado, 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, National Institute on Minority Health and Health Disparities
Awards: G1017836356, G1069896169, G1086024956, G1231470764, G14131799, G1428306231, G1457443466, G1657039673, G1697512176, G1738385447, G1764474367, G1826705250, G1840982552, G1950426917, G2017939603, G2037811546, G2053192733, G2059390010, G2191010568, G2527449299, G2552013629, G2640873770, G273771255, G2780371328, G2903706903, G3035227427, G3060641347, G3105508146, G3109772807, G316640966, G3192100241, G329385745, G3317573464, G3431956260, G3445156229, G3461265983, G346895651, G3480908756, General Clinical Research Center, G3528332946, G3529252663, G3533025948, G356129122, G3740841103, University of Pittsburgh Clinical and Translational Science Institute, G3760232349, G384675585, G3912236686, G3953056078, G3981800229, G399994722, G420249297, G4612287699, G4717514028, G4818134524, G4929737355, G4936150098, G5025251112, G5064254831, G5135479248, G517149770, G5265194600, G5354989911, G538488588, G5559485639, G5575737915, G5762116573, G5764153437, G5829401840, G5867119639, G5894676382, G5923072222, G5939482190, G595004201, G6070369395, G6077961426, G6118008579, G6138801743, G6174817875, G620556806, G6287513972, G6318709474, G6672857982, G6692712374, G66933475, G6756527295, G6805195085, G6814108493, G6838893258, G6860204850, G6985105270, G7073284033, G7321782777, G7370045261, G7377779347, G7479900841, G7608888979, G7632577458, G7641880336, G7685386930, G7713411732, G77314734, G8290600214, G8315761971, G8338615354, G8354416363, G8389659858, G860858521, G861407116, G8890933655, G8923095631, G9000013878, G9000030515, G9000041399, G9000074674, G9000085504, G9000113229, G9000141685, G9000221354, G902522517, G91250943, G94176081, G980169708
OpenAlex ID: W4293337152