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The Look AHEAD (Action for Health in Diabetes) study examined how a lifestyle intervention (diet and exercise), compared to diabetes support and education, may help to improve function in a population at high risk for cognitive decline—people with excess weight or obesity and type 2 diabetes.1 Lifestyle is a complex construct that includes behaviors such as cognitive and social engagement as well as diet choices and exercise. There is no clear consensus regarding the nature of the ideal choices and who gets to benefit by adhering. Much data regarding lifestyle come from observational studies, which by design cannot absolutely prove causation and might not motivate behavioral change. There are no proven pharmacologic interventions that prevent or treat cognitive decline, though modifiable risk factors might account for a substantial proportion of the risk for cognitive decline.2
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