Mary Beth Spitznagel1, Michael Alosco2, Thomas H Inge3, Amber Rochette2, Gladys Strain4, Michael Devlin5, Ross D Crosby6, James E Mitchell6, John Gunstad7. 1. Kent State University, Kent, Ohio; Summa Health System, Akron, Ohio. Electronic address: mspitzna@kent.edu. 2. Kent State University, Kent, Ohio. 3. Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio. 4. Weill Cornell Medical College, New York, New York. 5. Columbia University College of Physicians & Surgeons, New York, New York. 6. Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota. 7. Kent State University, Kent, Ohio; Summa Health System, Akron, Ohio.
Abstract
BACKGROUND: Cognitive deficits occur in a subset of individuals with obesity. Deficits can be reversed with bariatric surgery, though cognitive recovery is not equally exhibited across patients. Recent work has found that obesity during adolescence portends medical complications in adulthood; it is unknown if obesity in adolescence predicts adult cognition or cognitive recovery after weight loss surgery. OBJECTIVES: The present study examines the relationship between weight history and cognitive function in obese adults undergoing bariatric surgery. SETTING: Academic medical centers with bariatric care services. METHODS: Seventy-eight bariatric surgery patients (mean age = 43.2 years) enrolled in an ancillary study to the Longitudinal Assessment of Bariatric Surgery (LABS) project completed a questionnaire recalling weight history at age 18. Cognitive testing was completed preoperatively and at 12-month follow-up. RESULTS: Weight status at age 18 was linked to performance in several aspects of cognition. Higher body mass index at age 18 predicted poorer preoperative verbal fluency (B = -.26, P = .045) as well as postoperative cognitive recovery in attention (B = -.30, P = .01) at 12-month follow-up. CONCLUSION: Higher body mass index at age 18 predicts verbal fluency performance in adults with obesity, as well as postoperative recovery of attention after bariatric surgery. The mechanisms underlying this connection are not fully clear, though findings may reflect effects of obesity on the brain during a crucial period of neural maturation or duration of obesity and cumulative impact of co-morbidities on cognition. Future work examining possible causal factors involved in these relationships is needed.
BACKGROUND:Cognitive deficits occur in a subset of individuals with obesity. Deficits can be reversed with bariatric surgery, though cognitive recovery is not equally exhibited across patients. Recent work has found that obesity during adolescence portends medical complications in adulthood; it is unknown if obesity in adolescence predicts adult cognition or cognitive recovery after weight loss surgery. OBJECTIVES: The present study examines the relationship between weight history and cognitive function in obese adults undergoing bariatric surgery. SETTING: Academic medical centers with bariatric care services. METHODS: Seventy-eight bariatric surgery patients (mean age = 43.2 years) enrolled in an ancillary study to the Longitudinal Assessment of Bariatric Surgery (LABS) project completed a questionnaire recalling weight history at age 18. Cognitive testing was completed preoperatively and at 12-month follow-up. RESULTS: Weight status at age 18 was linked to performance in several aspects of cognition. Higher body mass index at age 18 predicted poorer preoperative verbal fluency (B = -.26, P = .045) as well as postoperative cognitive recovery in attention (B = -.30, P = .01) at 12-month follow-up. CONCLUSION: Higher body mass index at age 18 predicts verbal fluency performance in adults with obesity, as well as postoperative recovery of attention after bariatric surgery. The mechanisms underlying this connection are not fully clear, though findings may reflect effects of obesity on the brain during a crucial period of neural maturation or duration of obesity and cumulative impact of co-morbidities on cognition. Future work examining possible causal factors involved in these relationships is needed.
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