Abstract
Background
Growing evidence has shown that obesity is associated with poor neurocognitive outcomes.
Bariatric surgery has been shown to be an effective intervention for morbid obesity
and can result in improvement of many co-morbid medical conditions that are associated
with cognitive dysfunction. The effects of bariatric surgery on cognition are unknown.
Methods
We performed a prospective study total of 150 subjects (109 bariatric surgery patients
enrolled in the Longitudinal Assessment of Bariatric Surgery project and 41 obese
control subjects who had not undergone bariatric surgery). These 150 subjects completed
a cognitive evaluation at baseline and at 12 weeks of follow-up. The demographic,
medical, and psychosocial information was also collected to elucidate the possible
mechanisms of change.
Results
Many bariatric surgery patients exhibited impaired performance on cognitive testing
at baseline (range 4.6–23.9%). However, the surgery patients were no more likely to
exhibit a decline on ≥2 cognitive tests at 12 weeks of follow-up than were the obese
controls [12.84% versus 23.26%; chi-square (1) = 2.51, P = .11]. Group comparisons using repeated measures multivariate analysis of variance
showed that the surgery patients had improved memory performance at 12 weeks of follow-up
[λ = .86, F(4, 147) = 5.88, P <.001]; however, the memory performance of the obese controls had actually declined.
Regression analyses showed that the surgery patients without hypertension had better
short delay recall at 12 weeks than those with hypertension [β = .31, P = .005], although the other demographic and medical variables were largely unrelated
to the test performance.
Conclusion
The present results suggest that cognitive impairment is common in bariatric surgery
patients, although these deficits might be at least partly reversible. Future studies
are needed to clarify the underlying mechanisms, in particular, longitudinal studies
using neuroimaging and blood markers.
Keywords
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Article info
Publication history
Published online: October 04, 2010
Accepted:
September 21,
2010
Received:
June 25,
2010
Footnotes
This work supported by National Institutes of Health grant DK075119 with indirect support from grant HL089311.
Identification
Copyright
© 2011 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
