Neuropsychological Functioning in Mid-life Treatment-Seeking Adults with Obesity: a Cross-sectional Study
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The aim of this study is to compare cognitive functioning between treatment-seeking individuals with obesity and healthy-weight adults.
Design and Methods
Sixty-nine bariatric surgery candidates (BMI > 30 kg/m2) and 65 healthy-weight control participants (BMI 18.5–25 kg/m2) completed a neuropsychological battery and a self-report psychosocial questionnaire battery.
Hierarchical regression analyses indicated that obesity was predictive of poorer performance in the domains of psychomotor speed (p = .043), verbal learning (p < .001), verbal memory (p = .002), complex attention (p = .002), semantic verbal fluency (p = .009), working memory (p = .002), and concept formation and set-shifting (p = .003), independent of education. Obesity remained a significant predictor of performance in each of these domains, except verbal memory, following control for obesity-related comorbidities. Obesity was not predictive of visual construction, visual memory, phonemic verbal fluency or inhibition performance. Individuals with obesity also had significantly poorer decision-making compared to healthy-weight controls.
Findings support the contribution of obesity to selective aspects of mid-life cognition after controlling for obesity-related comorbidities, while addressing limitations of previous research including employment of an adequate sample, a healthy-weight control group and stringent exclusion criteria. Further investigation into the functional impact of such deficits, the mechanisms underlying these poorer cognitive outcomes and the impact of weight-loss on cognition is required.
KeywordsObesity Body mass index Cognition Bariatric surgery Executive function CVD risk factors
Compliance with Ethical Standards
Conflict of Interest
The authors declare they have no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.World Health Organization. Fact sheet: Obesity and overweight. Geneva: World Health Organization; 2013 [cited 2014 08/01/2014] Available from: http://www.who.int/mediacentre/factsheets/fs311/en/.
- 4.Anstey KJ, Cherbuin N, Budge M, et al. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev. 2011;12(5):e426-37. https://doi.org/10.1111/j.1467-789X.2010.00825.x.
- 13.National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Canberra: National Health and Medical Research Council; 2013.Google Scholar
- 14.WHO. BMI classification Geneva: World Health Organization; 2014 [cited 2014 08/01/2013] Available from: http://apps.who.int/bmi/index.jsp?introPage=intro_3.html.
- 16.Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMedGoogle Scholar
- 18.Inquisit 3 [Computer software]. 2011. Retrieved from http://www.millisecond.com.
- 19.Smith A. Symbol digit modalities test. Los Angeles: Western Psychological Services; 1991.Google Scholar
- 20.Delis DC, Kramer JH, Kaplan E, et al. California verbal learning test— second edition, adult version. San Antonio: Peason; 2000.Google Scholar
- 21.Meyers JE, Meyers KR. Rey complex figure test and recognition trial. Odessa: Psychological Assessment Resources; 1995.Google Scholar
- 23.Benton AL, Hamsher K, Sivan AB. Multilingual aphasia examination. 3rd ed. San Antonio: Psychological Corporation; 1994.Google Scholar
- 27.Heaton RK, Chelune GJ, Talley JL, et al. Wisconsin card sorting test (WCST) manual, revised and expanded. Odessa: Psychological Assessment Resources; 1993.Google Scholar
- 39.Jefferson AL, Massaro JM, Wolf PA, et al. Inflammatory biomarkers are associated with total brain volume: the Framingham heart study. Neurology. 2007;68(13):1032–8. https://doi.org/10.1212/01.wnl.0000257815.20548.df.CrossRefPubMedPubMedCentralGoogle Scholar
- 46.Liang J, Matheson BE, Kaye WH, et al. Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents. Int J Obes (Lond). 2014;38(4):494–506. https://doi.org/10.1038/ijo.2013.142.
- 50.Santry HP, Lauderdale DS, Cagney KA, et al. Predictors of patient selection in bariatric surgery. Ann Surg. 2007;245(1):59–67. https://doi.org/10.1097/01.sla.0000232551.55712.b3.CrossRefPubMedPubMedCentralGoogle Scholar
- 53.Auger RR. Sleep-related eating disorders. Psychiatry (Edgmont). 2006;3(11):64–70.Google Scholar