BACKGROUND: Postmenopausal women face a higher risk of obesity and related chronic diseases. While lifestyle interventions improve cardiometabolic health and physical function, their effects on cognitive function remain understudied, especially in diverse populations. This study examined the impact of a lifestyle intervention combining caloric restriction and exercise on cognitive function in a diverse sample of postmenopausal women with overweight or obesity and functional limitations. METHODS: This study represents a secondary analysis of a previously conducted pilot trial, in which 34 participants were randomly assigned to a 24-week intervention: (i) caloric restriction plus exercise (CR plus E; n = 17) or (ii) educational control (EC; n = 17). In the CR plus E group, participants engaged in group-based weight management focused on caloric restriction and three weekly exercise sessions, including walking and lower-body resistance training. The EC group attended monthly health education lectures. Changes in cognitive scores were assessed using the Digit Symbol Substitution Test (DSST) and the Controlled Oral Word Association (COWA) test. Additionally, we explored the correlation between changes in cognitive scores and physical function in the CR plus E group. RESULTS: In the CR plus E group, DSST scores significantly improved compared to the EC group (p < 0.05). There were no significant changes in COWA scores for either group compared to their baseline value or between groups. Furthermore, changes in DSST or COWA were not significantly correlated with changes in walking speed or physical function. CONCLUSIONS: The preliminary results of this study suggest that CR plus E may improve complex attention in functionally limited postmenopausal women with overweight or obesity but does not appear to significantly affect verbal fluency.

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