Bariatric surgery may mitigate the natural history of cognitive decline expected in people with obesity, a new study suggests.
Within the next 10 years, it’s projected that obesity will affect up to 50% of United States adults. Obesity is associated with cognitive impairment and dementia.
The findings, published in the Journal of Nutrition, Health & Aging, show that people with obesity who underwent bariatric surgery had stable cognition two years later.
“Since individuals with obesity experience more rapid cognitive decline than those without, stable cognition two years after bariatric surgery may be considered a success against historical trends, yet future controlled trials are needed to test this,” says first author Evan Reynolds, lead statistician for the NeuroNetwork for Emerging Therapies at the University of Michigan Medicine.
Using a collection of National Institutes of Health memory and language tests, as well as the Rey Auditory Verbal Learning Test, the research team assessed over 85 bariatric surgery patients at two-year follow up.
They found that NIH Cognitive Battery test scores remained stable, with secondary executive function tests showing improvement. One of the memory assessments, however, declined following surgery.
While this current study is the largest to assess changes two years after bariatric surgery, the researchers say, the results conflict with previous studies which found improved memory and executive functioning among similar patients.
“That study was primarily made up of patients who received gastric bypass, while our study was made up primarily of individuals that completed a sleeve gastrectomy,” Reynolds says.
“To provide the best evidence on the effectiveness of bariatric surgery on cognition and potential differences between surgery types, we must conduct larger observational studies or randomized, controlled trials.”
After bariatric surgery, improvements in diabetes complications, such as peripheral neuropathy, chronic kidney disease, and retinopathy, were not associated with improved cognition.
“Metabolic factors, including diabetes and obesity, are associated with cognitive decline, but we still need to better understand how best to treat these factors to improve patients’ cognitive outcomes,” says senior author Brian Callaghan, professor of neurology at the University of Michigan Medical School and a neurologist at University of Michigan Health.
The National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases supported the work.
Source: University of Michigan
