Executive Attentional Dyscontrol as a Core Cognitive and Behavioral Feature of Individuals with Obesity and Cardiovascular Disease: A Cross-Sectional Investigation

Abstract

Executive attention as a frontal domain ability that is effective in potentially blocking distracting information, reconciling conflicts among simultaneous attentional demands, and regulating impulsive behavior may be impaired in individuals with obesity and cardiovascular disease (CVD). This study aimed (i) to explore the presence of selected cognitive (global cognitive impairment, sensitivity to interference, and attention) and psychological (quality of life, depression, anxiety, and impulsivity) dimensions and (ii) to examine the interactive relationship between attentional dyscontrol—both as a psychological and as a cognitive measure—and the above-mentioned variables in a sample of patients with CVD attending a cardiac rehabilitation program across different body mass index (BMI) levels. Clinical information of 104 patients with CVD was retrospectively collected. Participants were classified into three groups according to their BMI as follows: normal weight (NW = 30), overweight (OW = 19), and obese (OB = 55). Individuals with CVD and a higher BMI showed problems in controlling executive attention—through both neuropsychological and behavioral measures. Specifically, OB patients demonstrated reduced sensitivity to cognitive interference, lower capabilities in divided attention during visual-tracking tasks, and greater impulsivity compared to NW patients. This behavioral characteristic was also found to be correlated with higher levels of anxiety and depression and a lower quality of life. Implications for cognitive rehabilitation were discussed to offer directions for better management of patients with CVD and obesity.

Exploring the Relationship of Anxiety and Depressive Symptoms and Impulsiveness with the Quality of Life of Older Patients with Cardiovascular Disease: A Cross-Sectional Study

“…Still, these results should be interpreted considering that the large majority of the sample had obesity as a comorbidity, and, as shown in previous studies [55], both motor and attentional impulsiveness are hard to detect in overweight or obese patients.…”

“…The findings of this study also suggest that BMI negatively correlated with the perceived QoL of the sample, although this association was less strong than those that QoL was shown to have with anxiety and depressive symptoms. Accordingly, evidence exists for the negative impact of a higher BMI on the QoL of individuals, and obesity was associated with the causal promotion of CVD in different studies [23,55,91]. When entered into the regression model, BMI alone significantly predicted 11.8% of the variance in QoL, which increased to 18.4% when impulsiveness was added to the model.…”

“…Research has indicated a detrimental impact of impulsivity on the cardiovascular system through an unfavorable lifestyle and biological actions that include endothelial damage and exaggerated reactivity to environmental stressors [23,55].…”

Inflammatory Pathways in Overweight and Obese Persons as a Potential Mechanism for Cognitive Impairment and Earlier Onset Alzeihmer’s Dementia in the General Population: A Narrative Review

“…Suboptimal executive functions, impaired decision-making, and impulsivity are frequently associated with addictions-of particular interest for us is food addiction [72]. Obese patients with cardiovascular disease showed a lower level of sensitivity to cognitive interference, lower abilities in divided attention during visual-tracking tasks, and greater impulsivity than normal-weight cardiovascular patients (as manifestations of attentional and executive dyscontrol) [73]. In another study, obese patients showed impaired performance on the decision-making task (Iowa gambling task) and performed the worst on the set-shifting task (Wisconsin Card Sorting Test).…”