@article{91bb618e3650493c85260ed43e8f92e2,
title = "Impact of an 8-Year Intensive Lifestyle Intervention on an Index of Multimorbidity",
abstract = "BACKGROUND/OBJECTIVES: Type 2 diabetes mellitus and obesity are sometimes described as conditions that accelerate aging. Multidomain lifestyle interventions have shown promise to slow the accumulation of age-related diseases, a hallmark of aging. However, they have not been assessed among at-risk individuals with these two conditions. We examined the relative impact of 8 years of a multidomain lifestyle intervention on an index of multimorbidity. DESIGN: Randomized controlled clinical trial comparing an intensive lifestyle intervention (ILI) that targeted weight loss through caloric restriction and increased physical activity with a control condition of diabetes support and education (DSE). SETTING: Sixteen U.S. academic centers. PARTICIPANTS: A total of 5,145 volunteers, aged 45 to 76, with established type 2 diabetes mellitus and overweight or obesity who met eligibility criteria for a randomized controlled clinical trial. MEASUREMENTS: A multimorbidity index that included nine age-related chronic diseases and death was tracked over 8 years of intervention delivery. RESULTS: Among individuals assigned to DSE, the multimorbidity index scores increased by an average of.98 (95% confidence interval [CI] =.94–1.02) over 8 years, compared with.89 (95% CI =.85–.93) among those in the multidomain ILI, which was a 9% difference (P =.003). Relative intervention effects were similar among individuals grouped by baseline body mass index, age, and sex, and they were greater for those with lower levels of multimorbidity index scores at baseline. CONCLUSIONS: Increases in multimorbidity over time among adults with overweight or obesity and type 2 diabetes mellitus may be slowed by multidomain ILI. J Am Geriatr Soc 68:2249–2256, 2020.",
keywords = "aging, multidomain intervention, obesity, type 2 diabetes mellitus",
author = "Espeland, {Mark A.} and Gaussoin, {Sarah A.} and Judy Bahnson and Vaughan, {Elizabeth M.} and Knowler, {William C.} and Simpson, {Felicia R.} and Hazuda, {Helen P.} and Johnson, {Karen C.} and Munshi, {Medha N.} and Mace Coday and Xavier Pi-Sunyer",
note = "Funding Information: This work is supported by the following cooperative agreements from the National Institutes of Health: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, DK110341, and DK56992. Felicia R. Simpson was funded by a diversity supplement to the Action for Health in Diabetes Extension Study Biostatistics Research Center (3U01DK057136-19S1). These federal agencies contributed support: National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; Office of Research on Women's Health; the National Institute on Aging; the Centers for Disease Control and Prevention; and the Department of Veterans Affairs. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service (IHS) provided personnel, medical oversight, and use of facilities. The opinions expressed in this article are those of the authors and do not necessarily reflect the views of the IHS or other funding sources. Additional support was received from the University of Pittsburgh General Clinical Research Center (GCRC) (M01RR000056), the Clinical Translational Research Center (CTRC) funded by the Clinical & Translational Science Award (UL1 RR 024153) and NIH grant (DK 046204); Frederic C. Bartter General Clinical Research Center (M01RR01346); and the Wake Forest Alzheimer's Disease Research Center (P30AG049638-01A1). These organizations have committed to make major contributions to Look AHEAD: FedEx Corporation; Health Management Resources; LifeScan, Inc, a Johnson & Johnson Company; OPTIFAST of Nestle HealthCare Nutrition, Inc; Hoffmann-La Roche Inc; Abbott Nutrition; and Slim-Fast Brand of Unilever North America. The authors have declared no conflicts of interest for this article. Conceived the manuscript, chaired the writing group, and drafted the manuscript: Espeland. Developed data sets, conducted analyses, and drafted sections: Gaussoin and Bahnson. Critically reviewed and edited the text: Vaughn, Knowler, Simpson, Hazuda, Johnson, Munshi, Coday, and Pi-Sunyer. Representatives from the National Institutes of Health collaborated on the design, conduct, and analysis of the study and the decision to submit the manuscript for publication. Funding Information: This work is supported by the following cooperative agreements from the National Institutes of Health: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, DK110341, and DK56992. Felicia R. Simpson was funded by a diversity supplement to the Action for Health in Diabetes Extension Study Biostatistics Research Center (3U01DK057136‐19S1). These federal agencies contributed support: National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; Office of Research on Women's Health; the National Institute on Aging; the Centers for Disease Control and Prevention; and the Department of Veterans Affairs. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service (IHS) provided personnel, medical oversight, and use of facilities. The opinions expressed in this article are those of the authors and do not necessarily reflect the views of the IHS or other funding sources. Funding Information: Additional support was received from the University of Pittsburgh General Clinical Research Center (GCRC) (M01RR000056), the Clinical Translational Research Center (CTRC) funded by the Clinical & Translational Science Award (UL1 RR 024153) and NIH grant (DK 046204); Frederic C. Bartter General Clinical Research Center (M01RR01346); and the Wake Forest Alzheimer's Disease Research Center (P30AG049638‐01A1). Publisher Copyright: {\textcopyright} 2020 The American Geriatrics Society",
year = "2020",
month = oct,
day = "1",
doi = "10.1111/jgs.16672",
language = "English (US)",
volume = "68",
pages = "2249--2256",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "10",
}