THE DIET STUDY - LONG-TERM OUTCOMES OF A COGNITIVE-BEHAVIORAL WEIGHT-CONTROL INTERVENTION IN INDEPENDENT-LIVING ELDERS

Objective To describe the long-term outcomes of a cognitive-behavioral weight-control intervention implemented in a community-based sample o f independent-living, older adults. Design A quasi-experimental design was used to compare an intervention community with a wait-listed cont rol community. Comparisons between the communities were made at 40 wee ks (J Am Diet Assoc. 1994;94:37-42). The controlled trial ended at 40 weeks; then both communities received 2 years of intervention. Two-yea r data from both communities were combined and are presented in this a rticle. Three-year outcome data from the initial intervention communit y were available and are also presented. Subjects A total of 247 overw eight (>4.5 kg of age-adjusted weight), older (mean age=71 years) adul ts in 2 independent-living retirement communities participated in the study. Intervention The Dietary intervention Evaluation of Technology (DIET) study consisted of an intensive 10-week psychoeducational appro ach focused on lifestyle change, followed by a less intensive a-year p hase focusing on relapse prevention and maintenance of lifestyle chang es. Outcome measures Physiologic and behavioral Variables were analyze d at baseline and at 2 years after baseline. This article reports the combined a-year outcome data from both retirement communities. Results of an additional follow-up 1 year after intervention was withdrawn ar e reported for the initial intervention community. Statistical analysi s A within-subjects repeated measures analysis of variance design was used to test for significant changes in weight and lipid values over t ime. Results At 2 years, 70% of those who started the intervention rem ained actively enrolled. This group showed significant decreases in bo dy mass index (-1.2, P<.001) and glucose level (-0.80 mmol/L, P<.001). Although high-density lipoprotein cholesterol (HDL-C) levels had incr eased at 40 weeks after baseline, this was not maintained at 2 years. AL the 3-year follow-up, changes in body mass index and glucose level were maintained. Applications/conclusions The purpose of this article was to describe the long-term outcomes of a community-based weight-red uction intervention for older adults. The findings may be of interest to clinicians who design community or worksite weight-reduction progra ms. Although the intervention was designed to be a low-intensity progr am, attrition over the length of the study was still problematic. Neve rtheless, our follow-up study indicates that this intervention was eff icacious in maintaining reductions in weight and glucose levels for ov erweight older adults for 3 years.