Physical and Cognitive Function - Look AHEAD Ancillary Study
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Purpose
Obesity is associated with physical disability through both direct pathways (e.g., lower extremity pain, insufficient muscle strength) and indirect pathways (obesity-related comorbidities and inflammation). Furthermore, diabetes, a major obesity-related health condition, is associated with increased risk of disability and accelerated declines in physical and cognitive function. The investigators preliminary data suggest that intentional weight loss improves physical function, and there is strong circumstantial evidence that it would also benefit cognitive function.
To evaluate the role of intentional weight loss on physical and cognitive function, the investigators propose an ancillary study to the on-going Look AHEAD (Action for Health in Diabetes) trial. Look AHEAD is a multi-center, randomized clinical trial to examine the effects of a 4-year lifestyle intervention designed to achieve and maintain weight loss through decreased caloric intake and exercise in overweight or obese men and women aged 45-74 years with type 2 diabetes. The investigators propose to add validated and well-established measures of physical and cognitive performance to the year 8 follow-up visit - during the trial's weight maintenance phase - in ~1000 participants at 4 of the 16 Look AHEAD field sites (Colorado, Memphis, Pennington and Pittsburgh).
The specific aims of this ancillary study are: 1) To determine the long-term effects of a lifestyle intervention designed to achieve and maintain weight loss on physical function; and 2) To determine the long-term effects of a lifestyle intervention designed to achieve and maintain weight loss on cognitive function. In addition, the investigators hypothesize that in the intervention group, larger initial weight loss, better weight loss maintenance, and higher physical activity will be associated with better physical and cognitive function. The investigators also hypothesize that in the control group weight loss will be associated with worse physical and cognitive function than in those who are weight stable or who have gained weight.
The number of obese older adults is rising rapidly and there are few data to guide an evidence-based clinical response to their management. The results of this study will provide the first direct evidence of the role of long-term intentional weight loss on the maintenance of physical and cognitive function in older obese adults with diabetes. Since this study is being done as an ancillary study to an on-going trial it can be done in a timely and cost-efficient manner.
| Condition | Intervention |
|---|---|
|
Diabetes Weight Loss Physical Function Cognitive Function |
Behavioral: Lifestyle intervention Behavioral: Diabetes Support Education |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Intentional Weight Reduction and Physical and Cognitive Function - A Look AHEAD Ancillary Study |
- SPPB [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- 400 m walk [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- Grip Stength [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- Knee extensor strength [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- Trail Making Test (A & B) [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- Digit Symbol Substitution Test (DSST) [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- Rey Auditory Verbal Learning Test (AVLT) [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- Modified Stroop Test [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
- Modified Mini-Mental Status Exam (3MS) [ Time Frame: These participants will have one visit at their year 8 or 9 of main study ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 1000 |
| Study Start Date: | September 2009 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Lifestyle intervention
Intensive Lifestyle Intervention that includes diet, physical activity, and behavior modification. The goal of the ILI intervention was for individuals to achieve and maintain a loss of at least 7% of initial body weight.
|
Behavioral: Lifestyle intervention
Intensive Lifestyle Intervention that includes diet, physical activity, and behavior modification. The goal of the ILI intervention was for individuals to achieve and maintain a loss of at least 7% of initial body weight.
|
|
Placebo Comparator: Diabetes Support and Education (DSE)
It offers an educational program to participants including developing support groups. Providing such benefits helps retain these participants in the trial.
|
Behavioral: Diabetes Support Education
It offers an educational program to participants including developing support groups. Providing such benefits helps retain these participants in the trial.
|
Eligibility| Ages Eligible for Study: | 45 Years to 74 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- The only inclusion criterion is that the participant is considered "active" at his/her Year 8 or Year 9 visit in the main study.
Exclusion Criteria:
- The only exclusion criterion is the person is not willing to participate in this ancillary study.
Contacts and Locations| United States, Colorado | |
| University of Colorado Health Sciences Center | |
| Aurora, Colorado, United States, 80045 | |
| United States, Louisiana | |
| Pennington Biomedical Research Center | |
| Baton Rouge, Louisiana, United States, 70801 | |
| United States, Pennsylvania | |
| University of Pittsburgh | |
| Pittsburgh, Pennsylvania, United States, 15203 | |
| United States, Tennessee | |
| The University of Tennessee-Memphis | |
| Memphis, Tennessee, United States, 38105 | |
| Principal Investigator: | Stephen B Kritchevsky, PhD | Wake Forest University |
More Information
Additional Information:
No publications provided
| Responsible Party: | Stephen Kritchevsky, Ph.D., Professor, Wake Forest University |
| ClinicalTrials.gov Identifier: | NCT01410097 History of Changes |
| Other Study ID Numbers: | R01 AG033087 |
| Study First Received: | July 8, 2011 |
| Last Updated: | December 19, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Weight Loss Body Weight Changes Body Weight Signs and Symptoms |
ClinicalTrials.gov processed this record on May 16, 2013