Long-term Impact of a 10-Year Intensive Lifestyle Intervention on a Deficit Accumulation Frailty Index: Action for Health in Diabetes Trial

Evans, Joni K.; Usoh, Chinenye O.; Simpson, Felicia R; Espinoza, Sara; Hazuda, Helen P.; Pandey, Ambarish; Beckner, Tara D.; Espeland, Mark

doi:10.1093/gerona/glad088

Cited by 8 publications

(5 citation statements)

References 28 publications

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“…These findings align those of Arakawa ( 45 ). In a study of an intervention trial conducted in a diabetic population with calorie restriction and increased physical activity and diet in the test group, the investigators found a relatively lower FI in the test group ( 46 ). Exercise has constructive impacts on nearly all body, particularly the skeletal system.…”

Section: Discussionmentioning

confidence: 99%

Association of altitude and frailty in Chinese older adults: using a cumulative frailty index model

Dong,

Ma,

Sun

et al. 2024

Front. Public Health

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ObjectiveThe population is aging exponentially and the resulting frailty is becoming increasingly evident. We aimed to explore the association between altitude and frailty, and to identify associated factors for frailty.MethodsThis is a community-based cross-sectional survey. 1,298 participants aged ≥60 years from three different altitudes were included in the study. To quantify frailty, we constructed a frailty index (FI) and a frailty score (FS). The FI was divided into non-frailty, prefrailty, and frailty. The Odds Ratios and confidence intervals (ORs, 95%CIs) were used to evaluate the association between altitude and FI and FS in multivariate ordinal logistic regression and linear regression.ResultsThere were 560 (53.1%) participants in the prefrailty and 488 (37.6%) in the frailty group. The FS increased with higher altitude (P for trend <0.001). Multivariate ordinal logistic regression analysis revealed an association between altitude and frailty, OR = 1.91 (95% CI: 1.38–2.64) in mid-high altitude and 2.49 (95% CI:1.40–4.45) in high altitude. The same trend of association was found in the univariate analysis. The FS increased by 1.69 (95% CI: 0.78–2.60) at mid-high altitude and 3.24 (95%CI:1.66–4.81) at high altitude compared to medium altitude.ConclusionThe study indicates that high altitude exposure is an associated factor for frailty in older adults. This association become stronger with higher altitudes. As a result, it is essential to conduct early frailty screening for residents living at high altitudes.

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Section: Discussionmentioning

confidence: 99%

Association of altitude and frailty in Chinese older adults: using a cumulative frailty index model

Dong,

Ma,

Sun

et al. 2024

Front. Public Health

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“…The benefits of BMI loss on FI may be larger than those for increased fitness, as seen in Figure 1 and Table 4; however, benefits for slowing the progression of FI associated with increased fitness were similar among those with BMI losses and BMI gains (based on the nonsignificant interactions). Across the full cohort, FI increased at a mean of about 0.01 units per year (37). Thus, the 4-yr differences seen in Figure 1, which range from about −0.02 to 0.03 units, may translate to 5-yr differences in “usual” aging in the Look AHEAD cohort.…”

Section: Discussionmentioning

confidence: 99%

Associations that Cardiorespiratory Fitness and Body Mass Index Loss Have with Deficit Accumulation Frailty

OLSON,

HOUSTON,

ROSS

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Introduction/Purpose Lower cardiorespiratory fitness and obesity may accelerate aging processes. The degree to which changes in fitness and body mass index (BMI) may alter the rate of aging may be important for planning treatment. We assessed cross-sectional and longitudinal associations that cardiorespiratory fitness and BMI had with a deficit accumulation frailty index. Methods Fitness, based on standardized graded exercise tests, and weight to calculate body mass index at baseline and year 4 were collected from 3,944 participants, ages 45-76, in the Action for Health in Diabetes (Look AHEAD) randomized controlled clinical trial. A validated 38-item deficit accumulation frailty index (FI) was used as a marker of aging. Associations between baseline and changes in fitness and BMI with changes in FI were assessed using linear models. Results Both baseline and 4-year changes in fitness and BMI were independently associated with 4-year changes in frailty (all p < 0.001). Mean [95% confidence interval] changes in FI ranged from -0.001 [-0.005,0.002] for participants in the group with the greatest fitness increase and BMI loss to 0.017 [0.013,0.020] for participants in the group with the greatest fitness loss and BMI gain. Associations of 4-year changes in fitness and BMI with FI changes were similar across subgroups based on age, gender, baseline BMI, diabetes duration, and cardiovascular disease history. Increased fitness across 4 years was associated with less FI accumulation independent of baseline fitness. Conclusions Adults with type 2 diabetes and overweight or obesity may slow aging processes captured by a FI by increasing their cardiorespiratory fitness and losing weight.

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“…Supporting analyses will compare the prevalence, severity, and change in the following geriatric syndromes: depression, pain, vision impairment, hearing impairment, nutritional risk, urinary incontinence, falls, fractures, sleep, polypharmacy, and weight and unintentional weight loss. Look AHEAD Aging will also describe differences between ILI and DSE in a frailty index based on deficit accumulation, modeled after the indices previously developed in Look AHEAD 29,30 …”

Section: Look Ahead Aging Protocolmentioning

confidence: 99%

“…Look AHEAD Aging will also describe differences between ILI and DSE in a frailty index based on deficit accumulation, modeled after the indices previously developed in Look AHEAD. 29 , 30 …”

Section: Look Ahead Aging Protocolmentioning

confidence: 99%

Rationale, design, and cohort characteristics of the Action for Health in Diabetes Aging study

Espeland,

Houston,

Hayden

et al. 2023

A&D Transl Res & Clin Interv

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INTRODUCTIONDiabetes and overweight/obesity are described as accelerating aging processes, yet many individuals with these conditions maintain high levels of cognitive and physical function and independence late into life. The Look AHEAD Aging study is designed to identify 20‐year trajectories of behaviors, risk factors, and medical history associated with resilience against geriatric syndromes and aging‐related cognitive and physical functional deficits among individuals with these conditions.METHODSLook AHEAD Aging extends follow‐up of the cohort of the former 10‐year Look AHEAD trial. The original cohort (N = 5145) was enrolled in 2001 to 2004 when participants were aged 45 to 76 years and randomly assigned to a multidomain intensive lifestyle intervention (ILI) or a diabetes support and education (DSE) condition. The trial interventions ceased in 2012. Clinic‐based follow‐up continued through 2020. In 2021, the cohort was invited to enroll in Look AHEAD Aging, an additional 4‐year telephone‐based follow‐up (every 6 months) enhanced with Medicare linkage. Standardized protocols assess multimorbidity, physical and cognitive function, health care utilization, and health‐related quality of life.RESULTSOf the original N = 5145 Look AHEAD participants, N = 1552 active survivors agreed to participate in Look AHEAD Aging. At consent, the cohort's mean age was 76 (range 63 to 94) years and participants had been followed for a mean of 20 years. Of the original Look AHEAD enrollees, those who were younger, female, or with no history of cardiovascular disease were more likely to be represented in the Look AHEAD Aging cohort. Intervention groups were comparable with respect to age, diabetes duration, body mass index, insulin use, hypertension, cardiovascular disease, and cognitive function. ILI participants had significantly lower deficit accumulation index scores.DISCUSSIONBy continuing the long‐term follow‐up of an extensively characterized cohort of older individuals with type 2 diabetes, Look AHEAD Aging is well positioned to identify factors associated with resilience against aging‐related conditions.

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Long-term Impact of a 10-Year Intensive Lifestyle Intervention on a Deficit Accumulation Frailty Index: Action for Health in Diabetes Trial

Cited by 8 publications

References 28 publications

Association of altitude and frailty in Chinese older adults: using a cumulative frailty index model

Association of altitude and frailty in Chinese older adults: using a cumulative frailty index model

Associations that Cardiorespiratory Fitness and Body Mass Index Loss Have with Deficit Accumulation Frailty

Rationale, design, and cohort characteristics of the Action for Health in Diabetes Aging study

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