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Obesity, a known risk factor for cognitive impairment and dementia, is anticipated to impact up to half of all adults in the United States over the next decade. In a groundbreaking study, researchers at Michigan Medicine have found that obese patients who undergo bariatric surgery experience stable cognition two years later.
Published in the Journal of Nutrition, Health & Aging, the study suggests that bariatric surgery may play a crucial role in mitigating the natural course of cognitive decline in obese adults. Evan Reynolds, Ph.D., the lead statistician for the NeuroNetwork for Emerging Therapies at Michigan Medicine and the first author of the study, emphasized the significance of their findings.
“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,” Reynolds stated.
The research team assessed over 85 bariatric surgery patients using a collection of memory and language tests developed by the National Institutes of Health, along with the Rey Auditory Verbal Learning Test. The results indicated that NIH Cognitive Battery test scores remained stable, with secondary executive function tests showing improvement. However, one of the memory assessments declined following surgery.
Notably, this study, the largest to assess changes two years after bariatric surgery, contradicts previous research that found improved memory and executive functioning among similar patients. Reynolds pointed out a potential reason for this inconsistency.
“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 explained. He stressed the need for larger observational studies or randomized, controlled trials to provide the best evidence on the effectiveness of bariatric surgery on cognition and potential differences between surgery types.
While bariatric surgery has demonstrated improvements in diabetes complications, such as peripheral neuropathy, chronic kidney disease, and retinopathy, the study found that these enhancements were not associated with improved cognition. Senior author Brian Callaghan, M.D., a neurologist at the University of Michigan Health, highlighted the importance of understanding how best to treat metabolic factors, including diabetes and obesity, to improve cognitive outcomes for patients.
The study raises hope for the potential cognitive benefits of bariatric surgery, but researchers underscore the need for further investigation to establish the long-term effects and determine the most effective surgical approaches for preserving cognitive function in obese individuals.
