Neuropsychological Functioning in Mid-life Treatment-Seeking Adults with Obesity: a Cross-sectional Study
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
- 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