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Obesity comorbidities impair attention, memory, processing speed
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Adults with class I or greater obesity may be more likely to have poorer cognitive function in the areas of attention, processing speed and executive functioning, if they also have diabetes or other comorbidities, according to findings published in Obesity.
“Intact cognition is obviously important for many reasons, including some related to behavioral health and the ability to modify risk factors. People with greater cognitive difficulties have a harder time changing behavior,” Ronald A. Cohen, PhD, ABPP, Evelyn McKnight chair of clinical translation in cognitive aging, professor of clinical and health psychology, neurology and psychiatry and director of the Center for Cognitive Aging and Memory at the University of Florida, in Gainesville, told Endocrine Today. “There is increasing evidence that obesity is a risk factor of age-associated cognitive decline and perhaps also neurodegenerative changes like Alzheimer's disease. Understanding these linkages is extremely important in this context.”
Cohen and colleagues analyzed data from 129 adults with a BMI of at least 35 kg/m2 (mean age, 45.65 years; 73.6% women; mean BMI, 45.42 kg/m2) who took part in the University of Florida’s Weight-loss Intervention Surgical Effects (WISE) Brain Study. Researchers conducted neurophysiological evaluations for attention, processing speed, memory, executive functioning and verbal fluency. Medical charts confirmed potential comorbidities, such as diabetes and sleep apnea.
According to the researchers, the entire cohort exhibited lower cognitive ability than what would be expected without any morbidities (P = .02). Processing speed (beta = –0.21; P = .05) and executive function (beta = –0.23; P = .03) were both negatively affected by the presence of diabetes, and the researchers noted that HbA1c was negatively associated with attention (beta = –0.29; P = .03) and total cognitive function (beta = –0.44; P = .002). They also found that memory, as measured via the California Verbal Learning Test (CVLT-II) total recall assessment, was worse with the presence of sleep apnea (beta = –0.3; P = .03), but that this could be reversed with the use of continuous positive airway pressure therapy (beta = 0.38; P = .006). Lastly, the researchers reported that verbal fluency was negatively affected by higher BMI (beta = –0.24; P = .02).
“Notably, BMI was not associated with cognitive performance in this cohort. This was a bit of a surprise given that we were examining obesity and cognition,” Cohen said. “However, examination of the reasons for this lack of relationship suggests that it likely reflects the fact that all participants in the cohort had very elevated BMI. Therefore, the results suggest that once a certain threshold of BMI is reached factors like whether comorbid diabetes exists become more important determinants of whether cognitive deficits will occur.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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