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Intensive lifestyle interventions slow multimorbidity gains in the long run in elderly adults

31 Jul 2020

Multidomain intensive lifestyle interventions (ILIs) may decelerate the accumulation of multimorbidity over time in overweight or obese elderly adults with type 2 diabetes, a recent study has shown.

Researchers performed a randomized controlled clinical trial on 5,145 volunteers (aged 45–76 years) with type 2 diabetes mellitus who were overweight or obese. The outcome was a multimorbidity index, which included conditions such as cancer, chronic kidney disease, congestive heart failure, hypertension, and stroke, among others. All-cause death was also included as an outcome component.

Interventions were ILI (n=2,570) and diabetes support and education (DSE; n=2,575). By the 8-year follow-up, multimorbidity scores had increased in both treatment arms, though the magnitude was greater in the DSE group (0.98 vs 0.89; p=0.003). Furthermore, multimorbidity scores increased in 63.3 percent of the DSE group, as opposed to only 59.6 percent of the ILI patients.

ILI showed relative superiority to DSE in terms of most components of the multimorbidity score. Most prominently, ILI yielded better results for chronic kidney disease (p=0.04) and hypertension (p=0.005). Cardiac arrhythmia and cancer scores were found to have greater increases in the ILI group, but the changes were not statistically significant.

Removing all-cause death from the composite had minimal effect on the principal outcome. ILI continued to yield lower 8-year increases in the multimorbidity index scores than DSE (mean difference, 0.08, 95 percent confidence interval, 0.02–0.13; p=0.006).

The researchers saw no significant subgroup effect on the effect of ILI vs DSE on multimorbidity scores according to baseline demographics.

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Most Read Articles
13 Sep 2020
Regardless of birth weight, being obese at preschool age is associated with a greater risk of elevated blood pressure during early childhood, a recent China study has found. A longer duration of breastfeeding appears to help mitigate such a risk.
Jairia Dela Cruz, 4 days ago
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
06 Sep 2020
Type 2 diabetes mellitus patients taking proton pump inhibitors (PPIs) are at a higher risk of sustaining hip fractures, a recent study has found.
6 days ago
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.