WINSTON-SALEM, N.C. – July 9, 2018 – The National Institutes of Health (NIH) has awarded $8 million to Wake Forest Baptist Medical Center to study cognitive decline and impairment in older adults with type 2 diabetes who are overweight or obese.
"It is critical to understand the role of lifestyle intervention for the treatment of type 2 diabetes and obesity," said one of the study's principal investigators, Mark Espeland, Ph.D., professor of public health sciences at Wake Forest Baptist. "Together, these two conditions nearly double one's risk for Alzheimer's disease and related dementias."
The four-year study, part of the NIH's Action for Health in Diabetes, will be led by Espeland, Kathleen Hayden, Ph.D., associate professor of public health sciences at Wake Forest Baptist, and Jose Luchsinger, M.D., associate professor of epidemiology and medicine at Columbia University. The study will build on earlier findings that intensive lifestyle intervention in overweight older adults with diabetes was associated with a 30 percent decrease in cognitive impairment. However, this potential benefit was not firmly established, necessitating additional research.
"If the findings hold, this will provide a powerful message to support lifestyle interventions in this rapidly growing population," Espeland said. "This new grant award will allow us to gather the additional data needed to confirm the initial findings."
The previous study showed that cognitive benefits from the intensive lifestyle intervention – reduced caloric intake and increased physical activity – did not appear to extend to those with the greatest levels of obesity. For these, paradoxically, the intensive lifestyle intervention appeared to increase rather than to decrease rates of cognitive impairment, Espeland said.
This new study will collect the additional data needed to confirm the earlier findings and to determine the mechanisms of action behind any benefits or risks. Participants will be enrolled at 16 sites across the United States.
"Funding for this additional research provides the unprecedented and timely opportunity to assess the legacy that a successful, sustained and well-documented lifestyle intervention has on cognitive resilience and the risk of Alzheimer's disease, related dementia and mild cognitive impairment in a large and diverse cohort drawn from across the country," Espeland said.
The NIH Action for Health in Diabetes study is the only randomized trial of long-term lifestyle intervention in people with type 2 diabetes. It has been coordinated by researchers at Wake Forest Baptist since 2000.
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