Older age does not limit postbariatric surgery cognitive benefits: a preliminary investigation

Abstract

Background Bariatric surgery is associated with cognitive benefits, but the nature of such gains may be variable across demographically and clinically diverse persons. Older adults achieve less weight loss and resolution of fewer medical comorbidities after surgery compared to younger patients, and are also at heightened risk for nutritional deficiencies. However, no study has examined the influence of age on cognitive improvements after bariatric surgery. Objective To determine the effects of age on cognitive function post-bariatric surgery. Setting Hospital. Methods 95 participants enrolled in the Longitudinal Assessment for Bariatric Surgery completed a computerized cognitive test battery prior to bariatric surgery and at 12-weeks, and 12-months post-operatively. Results Baseline cognitive impairments were common. Significant improvements were found in attention/executive function and memory abilities 12-weeks and 12-months after surgery. Age was not associated with baseline cognitive test performance. Separate multivariable regression analyses controlling for baseline attention/executive function and memory also showed that age was not a significant predictor of 12-week or 12-month performances in these domains (p > 0.05 for all). Conclusions The current study provides preliminary evidence suggesting that older age does not preclude post-bariatric surgery cognitive benefits. Prospective studies in more age diverse samples (i.e., up to 70 years) are needed to determine whether bariatric surgery can reduce risk of age-related neurological conditions like Alzheimer’s disease and stroke.

Changes in Cognitive Function Following Bariatric Surgery: a Systematic Review

“…Alosco 2014 [63] Age did not influence changes to cognitive performance in 95 bariatric surgery patients followed up at 12…”

Neurocognitive Effects of Obesity and Bariatric Surgery

“…Similarly, a comparison of individuals with and without a history of binge eating disorder showed no group differences over time (Lavender et al, ). Moreover, despite expectations that bariatric surgery patients of older age might show poorer cognitive resilience, older adults demonstrate no differences in the degree of cognitive benefits following bariatric surgery compared with younger individuals (Alosco et al, ). However, in contrast, individuals with a family history of Alzheimer's disease do not experience the same post‐operative improvements in memory performance that those without this family history do (Alosco et al, ), pointing to the possibility that a genetic vulnerability associated with this family history may attenuate cognitive recovery even in the absence of any neurologic symptoms.…”

Family history of Alzheimer’s disease limits improvement in cognitive function after bariatric surgery

“… 2 , 24 Age was not entered as a covariate, as a recent study shows that age does not influence post-surgery cognitive outcomes. 25 To capture the unique genetic variance of a family history of AD, we also controlled for a family history of other neurodegenerative disease that increase susceptibility to cognitive impairment during older age, including a family history of Parkinson’s disease and vascular dementia. Indeed, family history of Parkinson’s disease as well as neurodegenerative diseases more broadly is a significant risk factor for dementia, including AD.…”