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

Abstract Background Multidomain lifestyle interventions may slow aging as captured by deficit accumulation frailty indices; however, it is unknown whether benefits extend beyond intervention delivery. Methods We developed a deficit accumulation frailty index (FI-E) to span the 10 years that the Acti...

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Published in:The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2023-10, Vol.78 (11), p.2119-2126
Main Authors: Evans, Joni K, Usoh, Chinenye O, Simpson, Felicia R, Espinoza, Sara, Hazuda, Helen, Pandey, Ambarish, Beckner, Tara, Espeland, Mark A
Format: Article
Language:English
Subjects:
Aging
Body mass index
Cardiovascular diseases
Diabetes
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - therapy
Dietary restrictions
Frailty
Frailty - prevention & control
Humans
Intervention
Life Style
Lifestyles
Obesity
Overweight - therapy
Physical activity
THE JOURNAL OF GERONTOLOGY: Medical Sciences
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Summary:Abstract Background Multidomain lifestyle interventions may slow aging as captured by deficit accumulation frailty indices; however, it is unknown whether benefits extend beyond intervention delivery. Methods We developed a deficit accumulation frailty index (FI-E) to span the 10 years that the Action for Health in Diabetes (Look AHEAD) randomized controlled clinical trial delivered interventions (a multidomain lifestyle intervention focused on caloric restriction, increased physical activity, and diet compared to a control condition) and to extend across an additional 8 years post-delivery. The study cohort included 5 145 individuals, aged 45–76 years at enrollment, who had type 2 diabetes and either obesity or overweight. Results Overall, FI-E scores were relatively lower among lifestyle participants throughout follow-up, averaging 0.0130 [95% confidence interval: 0.0104, 0.0156] (p < .001) less across the 18 years. During Years 1–8, the mean relative difference between control and lifestyle participants’ FI-E scores was 0.0139 [0.0115, 0.0163], approximately 10% of the baseline level. During Years 9–18, this average difference was 0.0107 [0.0066, 0.0148]. Benefits were comparable for individuals grouped by baseline age and body mass index and sex but were not evident for those entering the trial with a history of cardiovascular disease. Conclusions Multidomain lifestyle intervention may slow biological aging long term, as captured by an FI-E. Clinical Trials Registration Number: NCT00017953
ISSN:1079-5006
1758-535X
DOI:10.1093/gerona/glad088