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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Long-term Impact of Behavioral Weight Loss Intervention on Cognitive Function</title>
<author><name sortKey="Espeland, Mark A" sort="Espeland, Mark A" uniqKey="Espeland M" first="Mark A." last="Espeland">Mark A. Espeland</name>
<affiliation><nlm:aff wicri:cut=" and" id="AF0001"><institution>Department of Biostatistical Sciences</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rapp, Stephen R" sort="Rapp, Stephen R" uniqKey="Rapp S" first="Stephen R." last="Rapp">Stephen R. Rapp</name>
<affiliation><nlm:aff id="AF0002"><institution>Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bray, George A" sort="Bray, George A" uniqKey="Bray G" first="George A." last="Bray">George A. Bray</name>
<affiliation><nlm:aff id="AF0003"><institution>Pennington Biomedical Research Center, Louisiana State University</institution>
,<addr-line>Baton Rouge</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Houston, Denise K" sort="Houston, Denise K" uniqKey="Houston D" first="Denise K." last="Houston">Denise K. Houston</name>
<affiliation><nlm:aff id="AF0004"><institution>Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Johnson, Karen C" sort="Johnson, Karen C" uniqKey="Johnson K" first="Karen C." last="Johnson">Karen C. Johnson</name>
<affiliation><nlm:aff wicri:cut=" and" id="AF0005"><institution>Department of Preventive Medicine</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kitabchi, Abbas E" sort="Kitabchi, Abbas E" uniqKey="Kitabchi A" first="Abbas E." last="Kitabchi">Abbas E. Kitabchi</name>
<affiliation><nlm:aff id="AF0006"><institution>Department of Medicine, University of Tennessee Health Science Center</institution>
,<addr-line>Memphis</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hergenroeder, Andrea L" sort="Hergenroeder, Andrea L" uniqKey="Hergenroeder A" first="Andrea L." last="Hergenroeder">Andrea L. Hergenroeder</name>
<affiliation><nlm:aff id="AF0007"><institution>Department of Physical Therapy, University of Pittsburgh</institution>
,<addr-line>Pennsylvania</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Williamson, Jeff" sort="Williamson, Jeff" uniqKey="Williamson J" first="Jeff" last="Williamson">Jeff Williamson</name>
<affiliation><nlm:aff id="AF0004"><institution>Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="AF0008"><institution>Kulynych Center for Memory and Cognition Research, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jakicic, John M" sort="Jakicic, John M" uniqKey="Jakicic J" first="John M." last="Jakicic">John M. Jakicic</name>
<affiliation><nlm:aff id="AF0009"><institution>Department of Health and Physical Activity, University of Pittsburgh</institution>
,<addr-line>Pennsylvania</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Van Dorsten, Brent" sort="Van Dorsten, Brent" uniqKey="Van Dorsten B" first="Brent" last="Van Dorsten">Brent Van Dorsten</name>
<affiliation><nlm:aff id="AF0010"><institution>Colorado Center for Behavioral Medicine</institution>
,<addr-line>Denver</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kritchevsky, Stephen B" sort="Kritchevsky, Stephen B" uniqKey="Kritchevsky S" first="Stephen B." last="Kritchevsky">Stephen B. Kritchevsky</name>
<affiliation><nlm:aff id="AF0004"><institution>Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">24619151</idno>
<idno type="pmc">4158413</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158413</idno>
<idno type="RBID">PMC:4158413</idno>
<idno type="doi">10.1093/gerona/glu031</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">000A77</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000A77</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Long-term Impact of Behavioral Weight Loss Intervention on Cognitive Function</title>
<author><name sortKey="Espeland, Mark A" sort="Espeland, Mark A" uniqKey="Espeland M" first="Mark A." last="Espeland">Mark A. Espeland</name>
<affiliation><nlm:aff wicri:cut=" and" id="AF0001"><institution>Department of Biostatistical Sciences</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rapp, Stephen R" sort="Rapp, Stephen R" uniqKey="Rapp S" first="Stephen R." last="Rapp">Stephen R. Rapp</name>
<affiliation><nlm:aff id="AF0002"><institution>Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bray, George A" sort="Bray, George A" uniqKey="Bray G" first="George A." last="Bray">George A. Bray</name>
<affiliation><nlm:aff id="AF0003"><institution>Pennington Biomedical Research Center, Louisiana State University</institution>
,<addr-line>Baton Rouge</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Houston, Denise K" sort="Houston, Denise K" uniqKey="Houston D" first="Denise K." last="Houston">Denise K. Houston</name>
<affiliation><nlm:aff id="AF0004"><institution>Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Johnson, Karen C" sort="Johnson, Karen C" uniqKey="Johnson K" first="Karen C." last="Johnson">Karen C. Johnson</name>
<affiliation><nlm:aff wicri:cut=" and" id="AF0005"><institution>Department of Preventive Medicine</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kitabchi, Abbas E" sort="Kitabchi, Abbas E" uniqKey="Kitabchi A" first="Abbas E." last="Kitabchi">Abbas E. Kitabchi</name>
<affiliation><nlm:aff id="AF0006"><institution>Department of Medicine, University of Tennessee Health Science Center</institution>
,<addr-line>Memphis</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hergenroeder, Andrea L" sort="Hergenroeder, Andrea L" uniqKey="Hergenroeder A" first="Andrea L." last="Hergenroeder">Andrea L. Hergenroeder</name>
<affiliation><nlm:aff id="AF0007"><institution>Department of Physical Therapy, University of Pittsburgh</institution>
,<addr-line>Pennsylvania</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Williamson, Jeff" sort="Williamson, Jeff" uniqKey="Williamson J" first="Jeff" last="Williamson">Jeff Williamson</name>
<affiliation><nlm:aff id="AF0004"><institution>Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="AF0008"><institution>Kulynych Center for Memory and Cognition Research, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jakicic, John M" sort="Jakicic, John M" uniqKey="Jakicic J" first="John M." last="Jakicic">John M. Jakicic</name>
<affiliation><nlm:aff id="AF0009"><institution>Department of Health and Physical Activity, University of Pittsburgh</institution>
,<addr-line>Pennsylvania</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Van Dorsten, Brent" sort="Van Dorsten, Brent" uniqKey="Van Dorsten B" first="Brent" last="Van Dorsten">Brent Van Dorsten</name>
<affiliation><nlm:aff id="AF0010"><institution>Colorado Center for Behavioral Medicine</institution>
,<addr-line>Denver</addr-line>
.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kritchevsky, Stephen B" sort="Kritchevsky, Stephen B" uniqKey="Kritchevsky S" first="Stephen B." last="Kritchevsky">Stephen B. Kritchevsky</name>
<affiliation><nlm:aff id="AF0004"><institution>Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journals of Gerontology Series A: Biological Sciences and Medical Sciences</title>
<idno type="ISSN">1079-5006</idno>
<idno type="eISSN">1758-535X</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background.</title>
<p>It is unknown whether intentional weight loss provides long-term benefits for cognitive function.</p>
</sec>
<sec><title>Methods.</title>
<p>An ancillary study to a randomized controlled clinical trial was conducted in overweight and obese individuals (<italic>N</italic>
= 978), aged 45–76 years at enrollment, with type 2 diabetes. An intensive behavioral intervention designed to promote and maintain weight loss through caloric restriction and increased physical activity was compared with diabetes support and education. Standardized assessments of cognitive function were collected an average of 8.1 years after trial enrollment.</p>
</sec>
<sec><title>Results.</title>
<p>Participants assigned to intensive lifestyle intervention lost a mean (<italic>SE</italic>
) 11.1% (0.4%) and 7.2% (0.5%) of weight at Years 1 and 8, respectively, compared with 1.0% (0.2%) and 3.3% (0.5%) in the control group (<italic>p</italic>
< .001). Covariate-adjusted mean composite cognitive function test scores were similar for the two groups (<italic>p</italic>
= .69), and no significant differences were found for any individual cognitive test. There was some evidence of a differential effect (nominal interaction <italic>p</italic>
= .008) for a prespecified comparison: Intensive lifestyle intervention was associated with a relative mean benefit for composite cognitive function of 0.276 (95% confidence interval: 0.033, 0.520) <italic>SD</italic>
s among individuals with body mass index less than 30kg/m<sup>2</sup>
at baseline compared with a relative mean deficit of 0.086 (−0.021, 0.194) <italic>SD</italic>
s among individuals with body mass more than or equal to 30kg/m<sup>2</sup>
.</p>
</sec>
<sec><title>Conclusions.</title>
<p>Eight years of intensive lifestyle intervention did not alter cognitive function in obese adults with type 2 diabetes; however, there was evidence for benefit among overweight but not obese individuals. Changes in cognition were not assessed in this cross-sectional study.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Gerontol A Biol Sci Med Sci</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Gerontol. A Biol. Sci. Med. Sci</journal-id>
<journal-id journal-id-type="hwp">gerona</journal-id>
<journal-id journal-id-type="publisher-id">gerona</journal-id>
<journal-title-group><journal-title>The Journals of Gerontology Series A: Biological Sciences and Medical Sciences</journal-title>
</journal-title-group>
<issn pub-type="ppub">1079-5006</issn>
<issn pub-type="epub">1758-535X</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
<publisher-loc>US</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24619151</article-id>
<article-id pub-id-type="pmc">4158413</article-id>
<article-id pub-id-type="doi">10.1093/gerona/glu031</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<series-title>Editor's choice</series-title>
</article-categories>
<title-group><article-title>Long-term Impact of Behavioral Weight Loss Intervention on Cognitive Function</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Espeland</surname>
<given-names>Mark A.</given-names>
</name>
<xref ref-type="aff" rid="AF0001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rapp</surname>
<given-names>Stephen R.</given-names>
</name>
<xref ref-type="aff" rid="AF0002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bray</surname>
<given-names>George A.</given-names>
</name>
<xref ref-type="aff" rid="AF0003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Houston</surname>
<given-names>Denise K.</given-names>
</name>
<xref ref-type="aff" rid="AF0004"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Johnson</surname>
<given-names>Karen C.</given-names>
</name>
<xref ref-type="aff" rid="AF0005"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kitabchi</surname>
<given-names>Abbas E.</given-names>
</name>
<xref ref-type="aff" rid="AF0006"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hergenroeder</surname>
<given-names>Andrea L.</given-names>
</name>
<xref ref-type="aff" rid="AF0007"><sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Williamson</surname>
<given-names>Jeff</given-names>
</name>
<xref ref-type="aff" rid="AF0004"><sup>4</sup>
</xref>
<xref ref-type="aff" rid="AF0008"><sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jakicic</surname>
<given-names>John M.</given-names>
</name>
<xref ref-type="aff" rid="AF0009"><sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>van Dorsten</surname>
<given-names>Brent</given-names>
</name>
<xref ref-type="aff" rid="AF0010"><sup>10</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kritchevsky</surname>
<given-names>Stephen B.</given-names>
</name>
<xref ref-type="aff" rid="AF0004"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><collab>for the Action for Health In Diabetes (Look AHEAD) Movement and Memory Subgroup and the Look AHEAD Research Group</collab>
</contrib>
<aff id="AF0001"><sup>1</sup>
<institution>Department of Biostatistical Sciences</institution>
and</aff>
<aff id="AF0002"><sup>2</sup>
<institution>Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</aff>
<aff id="AF0003"><sup>3</sup>
<institution>Pennington Biomedical Research Center, Louisiana State University</institution>
,<addr-line>Baton Rouge</addr-line>
.</aff>
<aff id="AF0004"><sup>4</sup>
<institution>Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</aff>
<aff id="AF0005"><sup>5</sup>
<institution>Department of Preventive Medicine</institution>
and</aff>
<aff id="AF0006"><sup>6</sup>
<institution>Department of Medicine, University of Tennessee Health Science Center</institution>
,<addr-line>Memphis</addr-line>
.</aff>
<aff id="AF0007"><sup>7</sup>
<institution>Department of Physical Therapy, University of Pittsburgh</institution>
,<addr-line>Pennsylvania</addr-line>
.</aff>
<aff id="AF0008"><sup>8</sup>
<institution>Kulynych Center for Memory and Cognition Research, Wake Forest School of Medicine</institution>
,<addr-line>Winston-Salem, North Carolina</addr-line>
.</aff>
<aff id="AF0009"><sup>9</sup>
<institution>Department of Health and Physical Activity, University of Pittsburgh</institution>
,<addr-line>Pennsylvania</addr-line>
.</aff>
<aff id="AF0010"><sup>10</sup>
<institution>Colorado Center for Behavioral Medicine</institution>
,<addr-line>Denver</addr-line>
.</aff>
</contrib-group>
<author-notes><corresp id="c1">Address correspondence to Mark A. Espeland, PhD, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. Email: <email>mespelan@wakehealth.edu</email>
</corresp>
<fn fn-type="other"><p><italic>Decision Editor: James Goodwin, PhD</italic>
</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>9</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>11</day>
<month>3</month>
<year>2014</year>
</pub-date>
<volume>69</volume>
<issue>9</issue>
<fpage>1101</fpage>
<lpage>1108</lpage>
<history><date date-type="received"><day>4</day>
<month>11</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>4</day>
<month>2</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract><sec><title>Background.</title>
<p>It is unknown whether intentional weight loss provides long-term benefits for cognitive function.</p>
</sec>
<sec><title>Methods.</title>
<p>An ancillary study to a randomized controlled clinical trial was conducted in overweight and obese individuals (<italic>N</italic>
= 978), aged 45–76 years at enrollment, with type 2 diabetes. An intensive behavioral intervention designed to promote and maintain weight loss through caloric restriction and increased physical activity was compared with diabetes support and education. Standardized assessments of cognitive function were collected an average of 8.1 years after trial enrollment.</p>
</sec>
<sec><title>Results.</title>
<p>Participants assigned to intensive lifestyle intervention lost a mean (<italic>SE</italic>
) 11.1% (0.4%) and 7.2% (0.5%) of weight at Years 1 and 8, respectively, compared with 1.0% (0.2%) and 3.3% (0.5%) in the control group (<italic>p</italic>
< .001). Covariate-adjusted mean composite cognitive function test scores were similar for the two groups (<italic>p</italic>
= .69), and no significant differences were found for any individual cognitive test. There was some evidence of a differential effect (nominal interaction <italic>p</italic>
= .008) for a prespecified comparison: Intensive lifestyle intervention was associated with a relative mean benefit for composite cognitive function of 0.276 (95% confidence interval: 0.033, 0.520) <italic>SD</italic>
s among individuals with body mass index less than 30kg/m<sup>2</sup>
at baseline compared with a relative mean deficit of 0.086 (−0.021, 0.194) <italic>SD</italic>
s among individuals with body mass more than or equal to 30kg/m<sup>2</sup>
.</p>
</sec>
<sec><title>Conclusions.</title>
<p>Eight years of intensive lifestyle intervention did not alter cognitive function in obese adults with type 2 diabetes; however, there was evidence for benefit among overweight but not obese individuals. Changes in cognition were not assessed in this cross-sectional study.</p>
</sec>
</abstract>
<kwd-group><title>Key Words:</title>
<kwd>Cognition</kwd>
<kwd>Obesity</kwd>
<kwd>Diabetes</kwd>
<kwd>Clinical trials.</kwd>
</kwd-group>
<counts><page-count count="8"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
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