Obesity Surgery

, Volume 23, Issue 10, pp 1527–1535 | Cite as

Bariatric Surgery Patients Exhibit Improved Memory Function 12 Months Postoperatively

  • Lindsay A. Miller
  • Ross D. Crosby
  • Rachel Galioto
  • Gladys Strain
  • Michael J. Devlin
  • Rena Wing
  • Ronald A. Cohen
  • Robert H. Paul
  • James E. Mitchell
  • John Gunstad
Original Contributions

Abstract

Background

Previous work from our group demonstrated improved memory function in bariatric surgery patients at 12 weeks postoperatively relative to controls. However, no study has examined longer-term changes in cognitive functioning following bariatric surgery.

Methods

A total of 137 individuals (95 bariatric surgery patients and 42 obese controls) were followed prospectively to determine whether postsurgery cognitive improvements persist. Potential mechanisms of change were also examined. Bariatric surgery participants completed self-report measurements and a computerized cognitive test battery prior to surgery and at 12-week and 12-month follow-up; obese controls completed measures at equivalent time points.

Results

Bariatric surgery patients exhibited cognitive deficits relative to well-established standardized normative data prior to surgery, and obese controls demonstrated similar deficits. Analyses of longitudinal change indicated an interactive effect on memory indices, with bariatric surgery patients demonstrating better performance postoperatively than obese controls.

Conclusions

While memory performance was improved 12 months postbariatric surgery, the mechanisms underlying these improvements were unclear and did not appear attributable to obvious postsurgical changes, such as reductions in body mass index or comorbid medical conditions. Future studies employing neuroimaging, metabolic biomarkers, and more precise physiological measurements are needed to determine the mechanisms underlying memory improvements following bariatric surgery.

Keywords

Obesity Cognitive function Bariatric surgery Longitudinal assessment 

Notes

Disclosures

No author has a conflict of interest for this work

References

  1. 1.
    Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303:235–41.PubMedCrossRefGoogle Scholar
  2. 2.
    Athyros VG, Tziomalos K, Karagiannis A, et al. Cardiovascular benefits of bariatric surgery in morbidly obese patients. Obes Rev. 2011;12:515–24.PubMedCrossRefGoogle Scholar
  3. 3.
    Paglieri C, Bisbocci D, Caserta M, et al. Hypertension and cognitive function. Clin Exp Hypertens. 2008;30:701–10.PubMedCrossRefGoogle Scholar
  4. 4.
    Kodl CT, Seaquist ER. Cognitive dysfunction and diabetes mellitus. Endocr Rev. 2008;29:494–511.PubMedCrossRefGoogle Scholar
  5. 5.
    Aloia MS, Arndett JT, Davis JD, et al. Neuropsychological sequelae of obstructive sleep apnea-hyponea syndrome: a critical review. J Int Neuropsychol Soc. 2004;10:772–85.PubMedCrossRefGoogle Scholar
  6. 6.
    Hassing LB, Dahl AK, Thorvaldsson V, et al. Overweight in midlife and risk of dementia: a 40-year follow-up study. Int J Obes. 2009;33:893–8.CrossRefGoogle Scholar
  7. 7.
    Strazzullo P, D’Elia L, Cairella G, et al. Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants. Stroke. 2010;41:e418–26.PubMedCrossRefGoogle Scholar
  8. 8.
    Gunstad J, Lhotsky A, Wendell CR, et al. Longitudinal examination of obesity and cognitive function: results from the Baltimore Longitudinal Study of Aging. Neuroepidemiology. 2010;34:222–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Gunstad J, Paul RH, Cohen RA, et al. Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Compr Psychiatry. 2007;48:57–61.PubMedCrossRefGoogle Scholar
  10. 10.
    Waldstein SR, Katzel LL. Interactive relations of central versus total obesity and blood pressure to cognitive function. Int J Obes. 2006;30:201–7.CrossRefGoogle Scholar
  11. 11.
    Gunstad J, Strain G, Devlin MJ, et al. Improved memory function 12 weeks after bariatric surgery. SOARD. 2011;7:465–72.Google Scholar
  12. 12.
    Siervo M, Arnold R, Wells JCK, et al. Intentional weight loss in overweight and obese individuals and cognitive function: a systematic review and meta-analysis. Obes Rev. 2011;12:968–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Belle SH, Berk PD, Courcoulas AP, et al. Safety and efficacy of bariatric surgery: Longitudinal Assessment of Bariatric Surgery. Surg Obes Relat Dis. 2007;3:116–26.PubMedCrossRefGoogle Scholar
  14. 14.
    Paul RH, Lawrence J, Williams LM, et al. Preliminary validity of “Integneuro”: a new computerized battery of neurocognitive tests. Int J Neurosci. 2005;115:1549–67.PubMedCrossRefGoogle Scholar
  15. 15.
    Williams LM, Simms E, Clark CR, et al. The test–retest reliability of a standardized neurocognitive and neurophysiological test battery: neuromarker. Int J Neurosci. 2005;115:1605–30.PubMedCrossRefGoogle Scholar
  16. 16.
    Reitan R. Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills. 1958;8:271–6.Google Scholar
  17. 17.
    Golden C. Stroop color and word task: a manual for clinical and experimental uses. Chicago: Stoeling; 1978.Google Scholar
  18. 18.
    Walsh K. Understanding brain damage—a primer of neuropsychological evaluation. Melbourne: Churchill Livingstone; 1985.Google Scholar
  19. 19.
    Naderali E, Ratcliffe SH, Dale MC. Obesity and Alzheimer’s disease: a link between body weight and cognitive function in old age. Am J Alzheimers Dis Other Demen. 2009;24:445–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Johnson DK, Wilkins CH, Morris JC. Accelerated weight loss may precede diagnosis in Alzheimer disease. Arch Neurol. 2006;63:1312–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Stewart R, Masaki K, Xue QL, et al. A 32-year prospective study of change in body weight and incident dementia: the Honolulu–Asia Aging Study. Arch Neurol. 2005;62:55–60.PubMedCrossRefGoogle Scholar
  22. 22.
    Gustafson D, Lissner L, Bengtsson C, et al. A 24-year follow-up of body mass index and cerebral atrophy. Neurology. 2004;63:1990–1.CrossRefGoogle Scholar
  23. 23.
    Gustafson DR, Steen B, Skoog I. Body mass index and white matter lesions in elderly women: an 18-year longitudinal study. Int Psychoger. 2004;16:327–36.CrossRefGoogle Scholar
  24. 24.
    Gunstad J, Paul R, Cohen R, et al. Relationship between body mass index and brain volume in healthy adults. Int J Neurosci. 2008;118:1582–93.PubMedCrossRefGoogle Scholar
  25. 25.
    Pannacciulli N, Del Parigi A, Chen K, et al. Brain abnormalities in human obesity: a voxel-based morphometric study. NeuroImage. 2006;31:1419–25.PubMedCrossRefGoogle Scholar
  26. 26.
    Taki Y, Kinomura S, Sato K, et al. Relationship between body mass index and gray matter volume in 1,428 healthy individuals. Obesity. 2008;16:119–24.PubMedCrossRefGoogle Scholar
  27. 27.
    Ward MA, Carlsson CM, Trivedi MA, et al. The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study. BMC Neurol. 2005;5:23.PubMedCrossRefGoogle Scholar
  28. 28.
    Jagust W, Harvey D, Mungas D, et al. Central obesity and the aging brain. Arch Neurol. 2005;62:1545–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Mrak RE. Alzheimer-type neuropathological changes in morbidly obese elderly individuals. ClinNeuropathol. 2009;28:40–5.Google Scholar
  30. 30.
    Smith PJ, Blumenthal JA, Babyak MA, et al. Effects of the dietary approaches to stopping hypertension diet, exercise, and caloric restriction in neurocognition in overweight adults with high blood pressure. Hypertension. 2010;55:1331–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Lindsay A. Miller
    • 1
  • Ross D. Crosby
    • 2
  • Rachel Galioto
    • 1
  • Gladys Strain
    • 3
  • Michael J. Devlin
    • 4
  • Rena Wing
    • 5
  • Ronald A. Cohen
    • 5
  • Robert H. Paul
    • 6
  • James E. Mitchell
    • 2
  • John Gunstad
    • 1
    • 7
  1. 1.Department of PsychologyKent State UniversityKentUSA
  2. 2.Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health SciencesFargoUSA
  3. 3.Weill Cornell Medical CollegeNew YorkUSA
  4. 4.Columbia University Medical CenterNew YorkUSA
  5. 5.Alpert Medical School of Brown UniversityProvidenceUSA
  6. 6.University of Missouri-St. LouisSt. LouisUSA
  7. 7.Summa Health SystemAkronUSA

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