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February 21, 2026Psychotherapy and Psychosomatics0 citations

Three-year effects of a multidomain lifestyle intervention on impulsivity: Results from a randomized clinical trial

CGCarlos Patricio Gómez-Martínez SSSangeetha Shyam LCLucia Camacho-Barcia

Key Points

This research aimed to evaluate the effects of a multidomain lifestyle intervention on impulsivity in older adults with overweight or obesity.
Participants from the PREDIMED-Plus-Cognition sub-study were followed for 3 years.
Eligible participants had overweight or obesity and metabolic syndrome.
Participants were randomized into an intensive intervention group or a control group with dietary advice.
Impulsivity was assessed using the UPPS-P Impulsive Behavior Scale and neuropsychological evaluations at multiple time points.
Multivariate linear mixed models analyzed the impact of the intervention on impulsivity.
Participants in the intensive intervention group showed significant reductions in Trait Impulsivity at 1 year.
At the 3-year follow-up, reductions in Global and Behavioral Impulsivity were also observed in the intensive intervention group.
Mean z-score changes indicated improvements in impulsivity compared to the control group at both follow-ups.

Abstract

Introduction: Research has consistently shown associations between elevated impulsivity and adverse physical and mental health outcomes. Specifically, impulsivity has been associated with higher body mass index and cardiometabolic issues. However, evidence from randomized clinical trials (RCTs) on whether impulsivity is responsive to a multidomain lifestyle intervention in older adults with overweight or obesity who are at high cardiovascular risk is limited. Methods: Participants from the PREDIMED-Plus-Cognition sub-study, followed for 3 years as part of the PREDIMED-Plus RCT, were included. Eligible participants had overweight or obesity and metabolic syndrome at baseline. Participants were randomly allocated to either an intensive intervention group (IIG), with an energy-restricted Mediterranean diet (MedDiet), physical activity, and behavioral support, or to a control group (CG), advised to follow an ad libitum MedDiet. The primary outcome of the current study was the evaluation of impulsivity, which was only assessed in participants from the PREDIMED-Plus-Cognition sub-study. Trait impulsivity was assessed using the UPPS-P Impulsive Behavior Scale and behavioral impulsivity through 4 neuropsychological evaluations at baseline, 1-year, and 3-year follow-ups. Z-score composites for Global, Trait, and Behavioral Impulsivity were estimated. Multivariate linear mixed models were used to assess the effect of the PREDIMED-Plus intervention on impulsivity among the participants who participated in the PREDIMED-Plus-Cognition sub-study. Results: A total of 306 participants (CG: n=156; IIG: n=150; mean age SD: 65.0 4.7 years; 45.7% female) had impulsivity data at baseline. Compared to the CG, participants in the IIG exhibited decreases in Trait Impulsivity at 1 year (mean z-score change 95%CI: -0.26 -0.49, -0.03), and in Global (-0.28 -0.52, -0.03) and Behavioral (-0.28 -0.54, -0.02) Impulsivity at 3-year follow-up. Conclusion: An intensive lifestyle intervention combining MedDiet, physical activity, and behavioral support resulted in a long-term reduction of impulsivity among older adults at high cardiometabolic risk. Public health guidelines may consider multidomain lifestyle intervention strategies to decrease impulsivity.

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