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

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.