TABLE 2.
Effects of diet, exercise, or a combination of both on cognition and mood in obese older adults1
| Baseline2 | Change at 6 mo3 | Change at 12 mo3 | Difference in change from baseline to 12 mo (95% CI) | P4 | |
| Main outcome | |||||
| 3MS | |||||
| Control group | 96.3 ± 0.8 | 0.1 ± 0.4 | 0.1 ± 0.4 | — | — |
| Diet group | 96.0 ± 0.6 | 1.1 ± 0.45 | 1.7 ± 0.45 | — | — |
| Exercise group | 94.9 ± 0.9 | 1.9 ± 0.45 | 2.8 ± 0.45 | — | — |
| Diet-exercise group | 95.6 ± 0.8 | 1.8 ± 0.45 | 2.9 ± 0.45 | — | — |
| Intergroup comparisons | |||||
| Diet vs control | — | — | — | 1.5 (0.1, 3.0) | 0.04 |
| Exercise vs control | — | — | — | 3.0 (1.5, 4.5) | 0.0001 |
| Diet-exercise vs control | — | — | — | 3.0 (1.5, 4.4) | 0.0001 |
| Diet-exercise vs diet | — | — | — | 1.4 (0.0, 2.8) | 0.04 |
| Diet-exercise vs exercise | — | — | — | 0.0 (−1.5, 1.4) | 0.99 |
| Other outcomes | |||||
| Word List Fluency | |||||
| Control group | 17.9 ± 1.1 | −0.4 ± 0.7 | −0.8 ± 0.8 | — | — |
| Diet group | 17.3 ± 0.7 | 1.3 ± 0.7 | 1.4 ± 0.7 | — | — |
| Exercise group | 17.9 ± 0.8 | 2.3 ± 0.75 | 4.1 ± 0.85 | — | — |
| Diet-exercise group | 19.5 ± 0.8 | 2.2 ± 0.75 | 4.2 ± 0.75 | — | — |
| Intergroup comparisons | |||||
| Diet vs control | — | — | — | 2.3 (−0.5, 5.0) | 0.11 |
| Exercise vs control | — | — | — | 4.9 (2.1, 7.7) | 0.001 |
| Diet-exercise vs control | — | — | — | 4.5 (1.8, 7.2) | 0.001 |
| Diet-exercise vs diet | — | — | — | 2.3 (−0.3, 4.9) | 0.08 |
| Diet-exercise vs exercise | — | — | — | −0.3 (−3.0, 2.3) | 0.80 |
| Trail A | |||||
| Control group | 42.9 ± 3.0 | −1.6 ± 2.0 | −0.8 ± 1.9 | — | — |
| Diet group | 41.8 ± 2.4 | −6.1 ± 2.05 | −7.1 ± 2.05 | — | — |
| Exercise group | 40.3 ± 2.3 | −5.1 ± 2.0 | −8.4 ± 2.15 | — | — |
| Diet-exercise group | 47.7 ± 5.6 | −7.4 ± 1.95 | −11.8 ± 1.95 | — | — |
| Intergroup comparisons | |||||
| Diet vs control | — | — | — | −5.8 (−13.2, 1.5) | 0.12 |
| Exercise vs control | — | — | — | −6.6 (−14.1, 0.8) | 0.08 |
| Diet-exercise vs control | — | — | — | −12.9 (−20.1, −5.8) | 0.001 |
| Diet-exercise vs diet | — | — | — | −7.1 (−14.3, 0.2) | 0.06 |
| Diet-exercise vs exercise | — | — | — | −6.3 (−13.6, 1.1) | 0.09 |
| Trail B | |||||
| Control group | 106.9 ± 7.8 | −0.9 ± 4.8 | −1.8 ± 4.9 | — | — |
| Diet group | 106.9 ± 9.3 | −15.4 ± 5.05 | −20.7 ± 5.25 | — | — |
| Exercise group | 102.5 ± 7.3 | −8.9 ± 5.15 | −16.1 ± 5.55 | — | — |
| Diet-exercise group | 102.2 ± 8.3 | −14.7 ± 4.85 | −21.8 ± 5.15 | — | — |
| Intergroup comparisons | |||||
| Diet vs control | — | — | — | −17.9 (−35.8, 0.3) | 0.05 |
| Exercise vs control | — | — | — | −12.6 (−31.2, 5.9) | 0.18 |
| Diet-exercise vs control | — | — | — | −18.1 (−36.1, 0.1) | 0.049 |
| Diet-exercise vs diet | — | — | — | −0.4 (−18.6, 18.3) | 0.98 |
| Diet-exercise vs exercise | — | — | — | −5.5 (−24.2, 13.3) | 0.56 |
| GDS | |||||
| Control group | 1.9 ± 0.6 | −0.7 ± 0.3 | −0.1 ± 0.4 | — | — |
| Diet group | 1.4 ± 0.5 | −0.6 ± 0.3 | −0.2 ± 0.3 | — | — |
| Exercise group | 1.5 ± 0.4 | −0.3 ± 0.3 | −0.3 ± 0.3 | — | — |
| Diet-exercise group | 1.0 ± 0.2 | 0.1 ± 0.2 | −0.4 ± 0.3 | — | — |
| Intergroup comparisons | |||||
| Diet vs control | — | — | — | 0.2 (−1.0, 1.3) | 0.78 |
| Exercise vs control | — | — | — | −0.1 (−1.2, 1.1) | 0.92 |
| Diet-exercise vs control | — | — | — | 0.1 (−1.1, 1.2) | 0.89 |
| Diet-exercise vs diet | — | — | — | −0.1 (−1.0, 0.9) | 0.87 |
| Diet-exercise vs exercise | — | — | — | 0.1 (−0.9, 1.2) | 0.77 |
The samples for analysis were n = 27 for the control group, n = 26 for the diet group, n = 26 for the exercise group, and n = 28 for the diet-exercise group. GDS, Geriatric Depression Scale; 3MS, Modified Mini-Mental State Examination; —, not applicable.
Values are observed means ± SEs.
Values are least-squares adjusted means ± SEs from the repeated-measures analysis.
P values for comparisons between groups for changes from baseline to 12 mo were calculated with the use of mixed-model repeated-measures ANOVA contrasts (with baseline values and education as covariates in analyses of cognitive tests and with baseline values as covariates in analyses of mood). The P value for the group × visit interaction for the main outcome of 3MS was 0.001. P values for the group × visit interaction for the other outcomes were 0.01 for Word Fluency, 0.04 for Trail A, 0.38 for Trail B, and 0.36 for the GDS.
P < 0.05 for the comparison of the value at the follow-up time with the within-group baseline value, as calculated with the use of mixed-model repeated-measures ANOVA.