The Cooperative Lifestyle Intervention Program-II (CLIP-II): Design and methods

Marsh, Anthony P.; Janssen, James A.; Ambrosius, Walter T.; Burdette, Jonathan H.; Gaukstern, Jill E.; Morgan, Ashley; Nesbit, Beverly A.; Paolini, J. Brielle; Sheedy, Jessica L.; Rejeski, W. Jack

doi:10.1016/j.cct.2013.08.006

Cited by 25 publications

(31 citation statements)

References 109 publications

(106 reference statements)

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“…Details of recruitment and baseline characteristics were published previously. 12 The mean age AE SD of included participants was 78.9 AE 5.2, 67.2% were women, 23.6% were racial or ethnic minorities, 35.9% were married, and 63.8% reported having a college education. In general, participants were cognitively intact (modified Mini-Mental State Examination score 91.7 AE 5.4), showed low levels of depressive symptoms (Center for Epidemiologic Studies Depression Scale score 8.5 AE 7.8), and had relatively poor sleep quality (Pittsburgh Sleep Quality Index score 5.9 AE 3.8).…”

Section: Resultsmentioning

confidence: 96%

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Device‐Measured Physical Activity As a Predictor of Disability in Mobility‐Limited Older Adults

Mankowski

Anton

Axtell

et al. 2017

J American Geriatrics Society

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Background The utility of wearable devices for objectively monitoring physical activity (PA) and predicting mobility disability in older adults is unknown. Objectives The aim of this analysis was to examine associations between objectively-measured PA and the incidence of major mobility disability (MMD) and persistent MMD (PMMD) among older adults in the Lifestyle Interventions and Independence for Elders (LIFE) Study. Design Prospective cohort of individuals aged 65 and older undergoing structured physical activity intervention or health education. Setting Eight sites. Participants LIFE Study participants (n=1590) had a mean age (SD) of 78.9 (5.2) years, with low levels of PA and measured mobility-relevant functional impairment at baseline. Measurements Activity data were collected by hip-worn 7-day accelerometer at baseline and 6, 12, and 24 months post-randomization to test for associations with incident MMD and PMMD (≥ 2 consecutive instances of MMD). Results At baseline, every 30 minutes spent being sedentary (<100 accelerometry counts per minute) was associated with higher rate of subsequent MMD (10%) and PMMD (11%) events. Every 500 steps taken was associated with lower rate of MMD (15%) and PMMD (18%). Similar associations were observed when fitting accelerometry-based PA as a time-dependent variable. Conclusion Accelerometry-based PA levels were strongly associated with the MMD and PMMD events among older adults with limited mobility. These results support the importance of daily PA and lower sedentary time levels in this population and suggest that accelerometry may be a useful tool for assessing risk for mobility disability.

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Section: Resultsmentioning

confidence: 96%

“…Details of recruitment and baseline characteristics were published previously . The mean age ± SD of included participants was 78.9 ± 5.2, 67.2% were women, 23.6% were racial or ethnic minorities, 35.9% were married, and 63.8% reported having a college education.…”

Section: Resultsmentioning

confidence: 99%

Device‐Measured Physical Activity As a Predictor of Disability in Mobility‐Limited Older Adults

Mankowski

Anton

Axtell

et al. 2017

J American Geriatrics Society

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“…Because these data come from an RCT of exercise and weight loss in older adults , treatment effects on mobility , body composition , and bone outcomes have been previously reported. Briefly, regarding body composition, significant reductions in total fat mass and total lean mass were observed in all groups over the 18‐month intervention period, with resistance exercise able to attenuate lean mass loss compared with aerobic exercise (−0.8 [SD 0.3] kg, −1.5% vs. −1.0 [SD 0.3] kg, −2.0%), and weight loss combined with either exercise modality augmented fat mass loss compared with weight loss alone (WL+AT: −6.8 [SD 0.6] kg, −16.4% and WL+RT: −7.8 [SD 0.5] kg, −19.0% vs. WL: −4.8 [SD 0.6] kg, −10.9%) .…”

Section: Resultsmentioning

confidence: 99%

“…Because these data come from an RCT of exercise and weight loss in older adults (25), treatment effects on mobility (26), body composition (27), and bone outcomes (28) have been previously reported. Briefly, regarding body composition, significant reductions in total fat mass and total lean mass were observed in all groups over the 18-month intervention period, with resistance exercise able to attenuate lean mass loss compared with aerobic exercise (−0.…”

Section: Intervention Effects On Fat Mass Lean Mass and Bone Massmentioning

confidence: 99%

Effect of Weight Change Following Intentional Weight Loss on Bone Health in Older Adults with Obesity

Kammire

Walkup

Ambrosius

et al. 2019

Obesity

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Objective This study aimed to examine change in bone mineral density (BMD) and trabecular bone score among older adult weight regainers (WR) and weight maintainers (WM). Methods Observational data come from 77 older adults (mean age: 67 [SD 5] years; 69% women; 70% white) with obesity (mean BMI: 33.6 [SD 3.7] kg/m2) who lost weight during an 18‐month weight loss intervention. Total body mass and body composition, along with regional (total hip, femoral neck, lumbar spine) BMD and trabecular bone score, were measured at baseline, 18 months, and 30 months. WR (n = 36) and WM (n = 41) categories were defined as a ≥ 5% or < 5% weight gain from 18 to 30 months, respectively. Results Among skeletal indices, only total hip BMD was significantly reduced during the 18‐month intervention period in both WRs (−3.9%; 95% CI: −5.8% to −2.0%) and WMs (−2.4%; 95% CI: −4.3% to −0.5%; P = 0.07). After adjustment for relevant baseline covariates and weight change from 0 to 18 months, 30‐month change in total hip BMD was −2.6% (95% CI: −4.3% to −0.9%) and −3.9% (95% CI: −5.7% to −2.1%) among WRs and WMs, respectively (P = 0.07). Conclusions Loss of hip BMD persists in the year after a weight loss intervention among older adults with obesity, regardless of weight regain status.

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“…In accordance with international recommendations, (35) bone formation marker Procollagen Type 1 N-Terminal Propeptide (P1NP), and bone resorption marker C-Terminal Telopeptide of Type 1 Collagen (CTX) were performed using commercially available ELISAs (NeoScientific, Cambridge, MA), as done previously. (39) …”

Section: Methodsmentioning

confidence: 99%

Effect of Exercise Modality During Weight Loss on Bone Health in Older Adults With Obesity and Cardiovascular Disease or Metabolic Syndrome: A Randomized Controlled Trial

Beavers

Walkup

Weaver

et al. 2018

Journal of Bone and Mineral Research

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The objective of this study was to determine the ability of either aerobic or resistance training to counter weight-loss-associated bone loss in older adults. There were 187 older adults (67 years, 70% women, 64% white) with obesity (BMI = 34.5 ± 3.7 kg/m ) and cardiovascular disease and/or metabolic syndrome who were randomized to participate in an 18-month, community-based trial, with a follow-up assessment at 30 months. Intervention arms included: weight loss alone (WL; 7% to 10% baseline weight), WL plus aerobic training (WL + AT), and WL plus resistance training (WL + RT), as well as DXA-acquired total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD), and trabecular bone score (TBS). Biomarkers of bone turnover (procollagen type 1 N-terminal propeptide, C-terminal telopeptide of type 1 collagen) were measured at baseline, 6, 18, and 30 (aBMD and TBS only) months. CT-acquired hip and spine volumetric BMD (vBMD), cortical thickness, and bone strength were measured in a subset at baseline (n = 55) and 18 months. Total hip aBMD was reduced by 2% in all groups at 18 months, with a primary analysis showing no significant treatment effects for any DXA, biomarker, or CT outcome. After adjustment for WL and follow-up at 30 months, secondary analyses revealed that total hip [-0.018 (-0.023 to -0.012) g/cm versus -0.025 (-0.031 to -0.019) g/cm ; p = 0.05] and femoral neck [-0.01 (-0.009 to 0.008) g/cm versus -0.011 (-0.020 to -0.002) g/cm ; p = 0.06] aBMD estimates were modestly attenuated in the WL + RT group compared with the WL group. Additionally, lumbar spine aBMD was increased in the WL [0.015 (0.007 to 0.024) g/cm ] and the WL + RT [0.009 (0.000 to 0.017) g/cm ] groups compared with the WL + AT [-0.003 (-0.012 to 0.005)g/cm ] group; both p ≤ 0.01. Community-based exercise does not prevent bone loss during active WL in older adults; however, adding RT may help minimize long-term hip bone loss. © 2018 American Society for Bone and Mineral Research.

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The Cooperative Lifestyle Intervention Program-II (CLIP-II): Design and methods

Cited by 25 publications

References 109 publications

Device‐Measured Physical Activity As a Predictor of Disability in Mobility‐Limited Older Adults

Device‐Measured Physical Activity As a Predictor of Disability in Mobility‐Limited Older Adults

Effect of Weight Change Following Intentional Weight Loss on Bone Health in Older Adults with Obesity

Effect of Exercise Modality During Weight Loss on Bone Health in Older Adults With Obesity and Cardiovascular Disease or Metabolic Syndrome: A Randomized Controlled Trial

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