Bariatric surgery and cognitive impairment

Abstract

Bariatric surgery has been shown to improve cognition in patients with severe obesity. Bariatric surgery may improve mental function in patient populations with obesity and with cognitive impairment, including nonacquired, dementia, and traumatic brain injury, although studies have been limited. Bariatric surgery provides an opportunity to explore the effects of obesity, type 2 diabetes, dyslipidemias, and other expressions of metabolic syndrome on cognition. It offers the unusual opportunity to study patients with these chronic diseases and, later, those without them. This suggests the need for further studies into the effects of bariatric surgery on patient populations with obesity and with cognitive impairment to look at the effects of the continuing metabolic brain damage in people with severe obesity when earlier intervention could be considered.

Sleeve Gastrectomy Reduces Glycemia but Does Not Affect Cognitive Impairment in Lean 5xFAD Mice

“…Some of the positive and negative effects of bariatric surgery were observed also in lean rodents, suggesting that the metabolic and endocrine state induced by surgery can have beneficial or detrimental physiolgoical effects ( Li et al, 2019 ; Ben-Haroush Schyr et al, 2021 ; Akalestou et al, 2022a ; Hefetz et al, 2022 ). Obesity is associated with cognitive decline and is a risk factor for AD ( Ahlskog et al, 2011 ; Ngandu et al, 2015 ; Spitznagel et al, 2015 ; Rochette et al, 2016 ; Stephen et al, 2017 ), and bariatric surgery was shown in most studies to improve cognitive function in patients with obesity ( Miller et al, 2013 ; Alosco et al, 2014a , b ; Spitznagel et al, 2015 ; Rochette et al, 2016 ; Thiara et al, 2017 ; Prehn et al, 2020 ; Morledge and Pories, 2021 ). This result can have two, non-mutually exclusive explanations: First, weight loss and improvement in metabolic parameters that are affected directly by obesity such as glycemia can reverse or delay cognitive decline.…”

Bariatric surgery outcomes in geriatric patients: a contemporary, nationwide analysis

“…Bariatric surgery has been shown to extend lifespan, improve cognitive function, and enhance quality of life [7,[20][21][22][23]. While there is consensus that surgery should be considered in patients younger than 50 years of age, the European Association for the Study of Obesity eliminates this age limit and encourages select elderly people to consider such operations [24].…”

Sleeve gastrectomy attenuated diabetes-related cognitive decline in diabetic rats

“…Bariatric surgery can ameliorate hyperglycemia ( 8 ) and reduce the body weight ( 9 ). In addition, patients underwent such type of surgery showed significant improvement in the cognitive function ( 10 ).…”