Longer Term Effects of Diet and Exercise on Neurocognition: 1‐Year Follow‐up of the ENLIGHTEN Trial
OBJECTIVES To evaluate the longer term changes in executive functioning among participants with cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND) randomized to a diet and exercise intervention. DESIGN A 2 (Exercise) × 2 (Dietary Approaches to Stop Hypertensi...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2020-03, Vol.68 (3), p.559-568 |
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| creator | Blumenthal, James A. Smith, Patrick J. Mabe, Stephanie Hinderliter, Alan Welsh‐Bohmer, Kathleen Browndyke, Jeffrey N. Doraiswamy, P. Murali Lin, Pao‐Hwa Kraus, William E. Burke, James R. Sherwood, Andrew |
| description | OBJECTIVES
To evaluate the longer term changes in executive functioning among participants with cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND) randomized to a diet and exercise intervention.
DESIGN
A 2 (Exercise) × 2 (Dietary Approaches to Stop Hypertension [DASH] eating plan) factorial randomized clinical trial.
SETTING
Academic tertiary care medical center.
PARTICIPANTS
Volunteer sample of 160 older sedentary adults with CIND and at least one additional CVD risk factor enrolled in the ENLIGHTEN trial between December 2011 and March 2016.
INTERVENTIONS
Six months of aerobic exercise (AE), DASH diet counseling, combined AE + DASH, or health education (HE) controls.
MEASUREMENTS
Neurocognitive battery recommended by the Neuropsychological Working Group for Vascular Cognitive Disorders including measures of executive function, memory, and language/verbal fluency. Secondary outcomes included the Clinical Dementia Rating‐Sum of Boxes (CDR‐SB), Six‐Minute Walk Distance (6MWD), and CVD risk including blood pressure, body weight, and CVD medication burden.
RESULTS
Despite discontinuation of lifestyle changes, participants in the exercise groups retained better executive function 1 year post‐intervention (P = .041) compared with non‐exercise groups, with a similar, albeit weaker, pattern in the DASH groups (P = .054), without variation over time (P's > .867). Participants in the exercise groups also achieved greater sustained improvements in 6MWD compared with non‐Exercise participants (P |
| doi_str_mv | 10.1111/jgs.16252 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7056586</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2317601365</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4432-abc236ae60f013edb165db8904dd042ae4d7c50810b5d54c4f4d0732e9708acf3</originalsourceid><addsrcrecordid>eNp1kUFvFCEYhonR2LX14B8wJF70sC0wwMx6MDF1uq3ZbA-uB0-EgW-mbGZhhRlrb_4Ef6O_RNatjW3idyGEhycvvAi9oOSY5jlZd-mYSibYIzShomBTwal4jCaEEDatJOUH6FlKa0IoI1X1FB0UtBR5yAR1i-A7iHgFcYPrtgUzJBxa_MHBgLW3uP4O0bgEOHi8hDEGEzrvBhf8W0x__fj5BXTEZ6Hvw3Xejdvd5eEKcL1cXMzPV_USr6LT_RF60uo-wfPb9RB9PqtXp-fTxeX84vT9Ymo4z8F1Y1ghNUjSElqAbagUtqlmhFtLONPAbWkEqShphBXc8JZbUhYMZiWptGmLQ_Ru792OzQasAT9E3attdBsdb1TQTt0_8e5KdeGbKomQopJZ8PpWEMPXEdKgNi4Z6HvtIYxJsfx3MmeTIqOvHqDrMEafn5cpOZMVLWc74Zs9ZWJIKUJ7F4YStatP5frUn_oy-_Lf9Hfk374ycLIHrl0PN_83qY_zT3vlb0G1pRk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2369681796</pqid></control><display><type>article</type><title>Longer Term Effects of Diet and Exercise on Neurocognition: 1‐Year Follow‐up of the ENLIGHTEN Trial</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Blumenthal, James A. ; Smith, Patrick J. ; Mabe, Stephanie ; Hinderliter, Alan ; Welsh‐Bohmer, Kathleen ; Browndyke, Jeffrey N. ; Doraiswamy, P. Murali ; Lin, Pao‐Hwa ; Kraus, William E. ; Burke, James R. ; Sherwood, Andrew</creator><creatorcontrib>Blumenthal, James A. ; Smith, Patrick J. ; Mabe, Stephanie ; Hinderliter, Alan ; Welsh‐Bohmer, Kathleen ; Browndyke, Jeffrey N. ; Doraiswamy, P. Murali ; Lin, Pao‐Hwa ; Kraus, William E. ; Burke, James R. ; Sherwood, Andrew</creatorcontrib><description>OBJECTIVES
To evaluate the longer term changes in executive functioning among participants with cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND) randomized to a diet and exercise intervention.
DESIGN
A 2 (Exercise) × 2 (Dietary Approaches to Stop Hypertension [DASH] eating plan) factorial randomized clinical trial.
SETTING
Academic tertiary care medical center.
PARTICIPANTS
Volunteer sample of 160 older sedentary adults with CIND and at least one additional CVD risk factor enrolled in the ENLIGHTEN trial between December 2011 and March 2016.
INTERVENTIONS
Six months of aerobic exercise (AE), DASH diet counseling, combined AE + DASH, or health education (HE) controls.
MEASUREMENTS
Neurocognitive battery recommended by the Neuropsychological Working Group for Vascular Cognitive Disorders including measures of executive function, memory, and language/verbal fluency. Secondary outcomes included the Clinical Dementia Rating‐Sum of Boxes (CDR‐SB), Six‐Minute Walk Distance (6MWD), and CVD risk including blood pressure, body weight, and CVD medication burden.
RESULTS
Despite discontinuation of lifestyle changes, participants in the exercise groups retained better executive function 1 year post‐intervention (P = .041) compared with non‐exercise groups, with a similar, albeit weaker, pattern in the DASH groups (P = .054), without variation over time (P's > .867). Participants in the exercise groups also achieved greater sustained improvements in 6MWD compared with non‐Exercise participants (P < .001). Participants in the DASH groups exhibited lower CVD risk relative to non‐DASH participants (P = .032); no differences in CVD risk were observed for participants in the Exercise groups compared with non‐Exercise groups (P = .711). In post hoc analyses, the AE + DASH group had better performance on executive functioning (P < .001) and CDR‐SB (P = .011) compared with HE controls.
CONCLUSION
For participants with CIND and CVD risk factors, exercise for 6 months promoted better executive functioning compared with non‐exercisers through 1‐year post‐intervention, although its clinical significance is uncertain. J Am Geriatr Soc 68:559–568, 2020</description><identifier>ISSN: 0002-8614</identifier><identifier>ISSN: 1532-5415</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.16252</identifier><identifier>PMID: 31755550</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Blood pressure ; Blood Pressure - physiology ; Body weight ; Cardiovascular diseases ; Cardiovascular Diseases - prevention & control ; Cardiovascular Diseases - therapy ; cardiovascular risk ; Clinical significance ; Cognition ; Cognitive ability ; cognitive impairment no dementia ; Dementia ; Dementia disorders ; Diet ; Dietary Approaches To Stop Hypertension ; Dietary Approaches to Stop Hypertension diet ; Executive function ; Executive Function - physiology ; executive functioning ; Exercise ; Exercise - physiology ; Female ; Follow-Up Studies ; Health Education ; Health risk assessment ; Humans ; Intervention ; Male ; Middle Aged ; Risk factors ; Time</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2020-03, Vol.68 (3), p.559-568</ispartof><rights>2019 The American Geriatrics Society</rights><rights>2019 The American Geriatrics Society.</rights><rights>2020 American Geriatrics Society and Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4432-abc236ae60f013edb165db8904dd042ae4d7c50810b5d54c4f4d0732e9708acf3</citedby><cites>FETCH-LOGICAL-c4432-abc236ae60f013edb165db8904dd042ae4d7c50810b5d54c4f4d0732e9708acf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.16252$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.16252$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31755550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blumenthal, James A.</creatorcontrib><creatorcontrib>Smith, Patrick J.</creatorcontrib><creatorcontrib>Mabe, Stephanie</creatorcontrib><creatorcontrib>Hinderliter, Alan</creatorcontrib><creatorcontrib>Welsh‐Bohmer, Kathleen</creatorcontrib><creatorcontrib>Browndyke, Jeffrey N.</creatorcontrib><creatorcontrib>Doraiswamy, P. Murali</creatorcontrib><creatorcontrib>Lin, Pao‐Hwa</creatorcontrib><creatorcontrib>Kraus, William E.</creatorcontrib><creatorcontrib>Burke, James R.</creatorcontrib><creatorcontrib>Sherwood, Andrew</creatorcontrib><title>Longer Term Effects of Diet and Exercise on Neurocognition: 1‐Year Follow‐up of the ENLIGHTEN Trial</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>OBJECTIVES
To evaluate the longer term changes in executive functioning among participants with cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND) randomized to a diet and exercise intervention.
DESIGN
A 2 (Exercise) × 2 (Dietary Approaches to Stop Hypertension [DASH] eating plan) factorial randomized clinical trial.
SETTING
Academic tertiary care medical center.
PARTICIPANTS
Volunteer sample of 160 older sedentary adults with CIND and at least one additional CVD risk factor enrolled in the ENLIGHTEN trial between December 2011 and March 2016.
INTERVENTIONS
Six months of aerobic exercise (AE), DASH diet counseling, combined AE + DASH, or health education (HE) controls.
MEASUREMENTS
Neurocognitive battery recommended by the Neuropsychological Working Group for Vascular Cognitive Disorders including measures of executive function, memory, and language/verbal fluency. Secondary outcomes included the Clinical Dementia Rating‐Sum of Boxes (CDR‐SB), Six‐Minute Walk Distance (6MWD), and CVD risk including blood pressure, body weight, and CVD medication burden.
RESULTS
Despite discontinuation of lifestyle changes, participants in the exercise groups retained better executive function 1 year post‐intervention (P = .041) compared with non‐exercise groups, with a similar, albeit weaker, pattern in the DASH groups (P = .054), without variation over time (P's > .867). Participants in the exercise groups also achieved greater sustained improvements in 6MWD compared with non‐Exercise participants (P < .001). Participants in the DASH groups exhibited lower CVD risk relative to non‐DASH participants (P = .032); no differences in CVD risk were observed for participants in the Exercise groups compared with non‐Exercise groups (P = .711). In post hoc analyses, the AE + DASH group had better performance on executive functioning (P < .001) and CDR‐SB (P = .011) compared with HE controls.
CONCLUSION
For participants with CIND and CVD risk factors, exercise for 6 months promoted better executive functioning compared with non‐exercisers through 1‐year post‐intervention, although its clinical significance is uncertain. J Am Geriatr Soc 68:559–568, 2020</description><subject>Aged</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Body weight</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Cardiovascular Diseases - therapy</subject><subject>cardiovascular risk</subject><subject>Clinical significance</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>cognitive impairment no dementia</subject><subject>Dementia</subject><subject>Dementia disorders</subject><subject>Diet</subject><subject>Dietary Approaches To Stop Hypertension</subject><subject>Dietary Approaches to Stop Hypertension diet</subject><subject>Executive function</subject><subject>Executive Function - physiology</subject><subject>executive functioning</subject><subject>Exercise</subject><subject>Exercise - physiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health Education</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Intervention</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Risk factors</subject><subject>Time</subject><issn>0002-8614</issn><issn>1532-5415</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUFvFCEYhonR2LX14B8wJF70sC0wwMx6MDF1uq3ZbA-uB0-EgW-mbGZhhRlrb_4Ef6O_RNatjW3idyGEhycvvAi9oOSY5jlZd-mYSibYIzShomBTwal4jCaEEDatJOUH6FlKa0IoI1X1FB0UtBR5yAR1i-A7iHgFcYPrtgUzJBxa_MHBgLW3uP4O0bgEOHi8hDEGEzrvBhf8W0x__fj5BXTEZ6Hvw3Xejdvd5eEKcL1cXMzPV_USr6LT_RF60uo-wfPb9RB9PqtXp-fTxeX84vT9Ymo4z8F1Y1ghNUjSElqAbagUtqlmhFtLONPAbWkEqShphBXc8JZbUhYMZiWptGmLQ_Ru792OzQasAT9E3attdBsdb1TQTt0_8e5KdeGbKomQopJZ8PpWEMPXEdKgNi4Z6HvtIYxJsfx3MmeTIqOvHqDrMEafn5cpOZMVLWc74Zs9ZWJIKUJ7F4YStatP5frUn_oy-_Lf9Hfk374ycLIHrl0PN_83qY_zT3vlb0G1pRk</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Blumenthal, James A.</creator><creator>Smith, Patrick J.</creator><creator>Mabe, Stephanie</creator><creator>Hinderliter, Alan</creator><creator>Welsh‐Bohmer, Kathleen</creator><creator>Browndyke, Jeffrey N.</creator><creator>Doraiswamy, P. Murali</creator><creator>Lin, Pao‐Hwa</creator><creator>Kraus, William E.</creator><creator>Burke, James R.</creator><creator>Sherwood, Andrew</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202003</creationdate><title>Longer Term Effects of Diet and Exercise on Neurocognition: 1‐Year Follow‐up of the ENLIGHTEN Trial</title><author>Blumenthal, James A. ; Smith, Patrick J. ; Mabe, Stephanie ; Hinderliter, Alan ; Welsh‐Bohmer, Kathleen ; Browndyke, Jeffrey N. ; Doraiswamy, P. Murali ; Lin, Pao‐Hwa ; Kraus, William E. ; Burke, James R. ; Sherwood, Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4432-abc236ae60f013edb165db8904dd042ae4d7c50810b5d54c4f4d0732e9708acf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Body weight</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Cardiovascular Diseases - therapy</topic><topic>cardiovascular risk</topic><topic>Clinical significance</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>cognitive impairment no dementia</topic><topic>Dementia</topic><topic>Dementia disorders</topic><topic>Diet</topic><topic>Dietary Approaches To Stop Hypertension</topic><topic>Dietary Approaches to Stop Hypertension diet</topic><topic>Executive function</topic><topic>Executive Function - physiology</topic><topic>executive functioning</topic><topic>Exercise</topic><topic>Exercise - physiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health Education</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Intervention</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Risk factors</topic><topic>Time</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blumenthal, James A.</creatorcontrib><creatorcontrib>Smith, Patrick J.</creatorcontrib><creatorcontrib>Mabe, Stephanie</creatorcontrib><creatorcontrib>Hinderliter, Alan</creatorcontrib><creatorcontrib>Welsh‐Bohmer, Kathleen</creatorcontrib><creatorcontrib>Browndyke, Jeffrey N.</creatorcontrib><creatorcontrib>Doraiswamy, P. Murali</creatorcontrib><creatorcontrib>Lin, Pao‐Hwa</creatorcontrib><creatorcontrib>Kraus, William E.</creatorcontrib><creatorcontrib>Burke, James R.</creatorcontrib><creatorcontrib>Sherwood, Andrew</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blumenthal, James A.</au><au>Smith, Patrick J.</au><au>Mabe, Stephanie</au><au>Hinderliter, Alan</au><au>Welsh‐Bohmer, Kathleen</au><au>Browndyke, Jeffrey N.</au><au>Doraiswamy, P. Murali</au><au>Lin, Pao‐Hwa</au><au>Kraus, William E.</au><au>Burke, James R.</au><au>Sherwood, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Longer Term Effects of Diet and Exercise on Neurocognition: 1‐Year Follow‐up of the ENLIGHTEN Trial</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2020-03</date><risdate>2020</risdate><volume>68</volume><issue>3</issue><spage>559</spage><epage>568</epage><pages>559-568</pages><issn>0002-8614</issn><issn>1532-5415</issn><eissn>1532-5415</eissn><abstract>OBJECTIVES
To evaluate the longer term changes in executive functioning among participants with cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND) randomized to a diet and exercise intervention.
DESIGN
A 2 (Exercise) × 2 (Dietary Approaches to Stop Hypertension [DASH] eating plan) factorial randomized clinical trial.
SETTING
Academic tertiary care medical center.
PARTICIPANTS
Volunteer sample of 160 older sedentary adults with CIND and at least one additional CVD risk factor enrolled in the ENLIGHTEN trial between December 2011 and March 2016.
INTERVENTIONS
Six months of aerobic exercise (AE), DASH diet counseling, combined AE + DASH, or health education (HE) controls.
MEASUREMENTS
Neurocognitive battery recommended by the Neuropsychological Working Group for Vascular Cognitive Disorders including measures of executive function, memory, and language/verbal fluency. Secondary outcomes included the Clinical Dementia Rating‐Sum of Boxes (CDR‐SB), Six‐Minute Walk Distance (6MWD), and CVD risk including blood pressure, body weight, and CVD medication burden.
RESULTS
Despite discontinuation of lifestyle changes, participants in the exercise groups retained better executive function 1 year post‐intervention (P = .041) compared with non‐exercise groups, with a similar, albeit weaker, pattern in the DASH groups (P = .054), without variation over time (P's > .867). Participants in the exercise groups also achieved greater sustained improvements in 6MWD compared with non‐Exercise participants (P < .001). Participants in the DASH groups exhibited lower CVD risk relative to non‐DASH participants (P = .032); no differences in CVD risk were observed for participants in the Exercise groups compared with non‐Exercise groups (P = .711). In post hoc analyses, the AE + DASH group had better performance on executive functioning (P < .001) and CDR‐SB (P = .011) compared with HE controls.
CONCLUSION
For participants with CIND and CVD risk factors, exercise for 6 months promoted better executive functioning compared with non‐exercisers through 1‐year post‐intervention, although its clinical significance is uncertain. J Am Geriatr Soc 68:559–568, 2020</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31755550</pmid><doi>10.1111/jgs.16252</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the American Geriatrics Society (JAGS), 2020-03, Vol.68 (3), p.559-568 |
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| language | eng |
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| source | MEDLINE; Wiley Journals |
| subjects | Aged Blood pressure Blood Pressure - physiology Body weight Cardiovascular diseases Cardiovascular Diseases - prevention & control Cardiovascular Diseases - therapy cardiovascular risk Clinical significance Cognition Cognitive ability cognitive impairment no dementia Dementia Dementia disorders Diet Dietary Approaches To Stop Hypertension Dietary Approaches to Stop Hypertension diet Executive function Executive Function - physiology executive functioning Exercise Exercise - physiology Female Follow-Up Studies Health Education Health risk assessment Humans Intervention Male Middle Aged Risk factors Time |
| title | Longer Term Effects of Diet and Exercise on Neurocognition: 1‐Year Follow‐up of the ENLIGHTEN Trial |
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