Healthy lifestyle intervention impacts on cognition and habits for individuals with traumatic brain injury: Secondary analysis of a randomized controlled trial.

ABSTRACTTo examine the impact of a healthy lifestyle intervention adapted for survivors of traumatic brain injury (TBI) classified as overweight or obese on cognition and habits. Setting is community-based intervention. Participants (n = 57) were adult survivors of moderate or severe TBI at least 6-month post-injury with a body mass index of ≥25 kg/m2. We conducted secondary analysis of a 12-month randomized controlled trial of a healthy lifestyle intervention (GLB-TBI) compared to an attention control group (BHG); primary study analyses previously demonstrated statistically and clinically significant weight loss of 7.9%, enhanced blood pressure, improved lipids, and good attendance and self-monitoring. Primary outcomes included the Montreal Cognitive Assessment and the Self-Report Habit Index. Average cognitive function for the GLB-TBI group significantly improved, whereas the average score for BHG decreased (β = 1.8 [0.29, 3.31]; p = 0.02). There were no significant differences in perceived habit strength. Although both groups perceived improvement in healthy habits, only the GLB-TBI group focused on evidence-based dietary and physical activity changes, resulted in improved cognitive function. Healthcare providers should consider referrals for healthy lifestyle interventions for survivors of brain injury who are overweight/obese, particularly for those experiencing sustained cognitive deficits.