516-P: Objective and Subjective Physical and Mental Health Benefits in Older Adults with Cardiometabolic Risk after Diabetes Prevention Program (DPP)-Based Lifestyle Intervention

Abstract

Physical function, health-related quality of life (HRQoL), and depressive symptoms are key outcomes for older adults (≥65y) enrolled in behavioral weight management, but less is known about relationships among these variables. We evaluated associations between changes in these measures after a 1-year DPP-based lifestyle program. Participants (N=322) were M±SD age 71.2y±4.3, BMI 33.8±5.1, 77% women, 13% Black, averaged 4 chronic conditions, and 31% had prediabetes. Most took blood pressure (67%) and lipid (52%) medications. Participants attended 12 in-person weekly groups, then were randomized to continued monthly contact by phone or newsletter, losing 7.4% (CI) (-8.9, -5.9) and 6.1% (-8.6, -3.6) of weight at 1 year, respectively. Goals included reducing calorie/fat intake, increasing lean protein, ≥150 minutes aerobic activity/week, and strength training. Physical function was measured via Short Physical Performance Battery (SPPB) gait speed, chair rise, and balance tests, perceived HRQoL via SF-12 Physical and Mental Component Summary (PCS and MCS), and mood via Center for Epidemiologic Studies Depression Scale (CES-D) at pre- and post-intervention. Associations between baseline-12 month changes in SPPB, HRQoL and CES-D were estimated in mixed-effect models. SPPB improved by 0.3±1.4 (p=0.001) in phone and 0.3±1.7 (p=0.02) in newsletter. Increased SPPB was associated with improved PCS (β=1.18, SE=0.20, p<0.001) and CES-D (β=-0.50, SE=0.17, p=0.002) in all participants, and improved MCS in phone (β=0.19, SE=0.28, p=0.049) and decreased MCS in newsletter (β=-0.37, SE=0.22, p=0.049). After weight loss, regardless of follow-up mode, modestly improved physical function relates to greater perceived physical HRQoL and mood, but less change in perceived mental HRQoL. Future weight loss trials in high risk elders should evaluate how to optimize physical function and subjective well-being outcomes. Disclosure H. J. Stern: None. R. G. Miller: None. R. P. K. Conlon: None. M. D. Levine: None. M. D. Marcus: Advisory Panel; Self; Weight Watchers International, Inc. E. M. Venditti: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R18DK096405)