Obesity and Lowered Cognitive Performance in a Canadian First Nations Population

Abstract

The association between obesity, other cardiovascular risk factors, and cognitive function in a Canadian First Nations population was investigated using a cross‐sectional design. Eligible individuals were aged ≥18 years, without a history of stroke, nonpregnant, with First Nations status, and who had undergone cognitive function assessment by the Clock Drawing Test (CDT) and Trail Making Test Parts A and B. Parts A and B were combined into an Executive Function Score (TMT‐exec). Hypertension, a previous history of cardiovascular disease, dyslipidemia, metabolic syndrome, insulin resistance, and the presence and duration of diabetes were examined in addition to obesity. In the case of TMT‐exec only, obese individuals were at an approximately fourfold increased risk for lowered cognitive performance compared to those who were not obese in multivariable models (odds ratio (OR): 3.77, 95% confidence interval (CI): 1.46–9.72) whereas there was no effect for overweight individuals compared to those with a normal weight in unadjusted analysis. Those having an increased waist circumference also had 5 times the risk compared to those without an increased waist circumference (OR: 5.41, 95% CI: 1.83–15.99). Adjusted for age, sex, and insulin resistance, individuals having the metabolic syndrome were at an approximately fourfold increased risk compared to those without the metabolic syndrome (OR: 3.67, 95% CI: 1.34–10.07). No other cardiovascular risk factors were associated. Obesity and metabolic syndrome were associated with lowered cognitive performance. These results highlight the importance of studying the health effects of obesity beyond traditional disease endpoints, even in a relatively youthful population.

Hypothalamic Damage Is Associated With Inflammatory Markers and Worse Cognitive Performance in Obese Subjects

“…Obesity is also well known to affect cognitive performance (18,19). To our knowledge, this would be the first study exploring cognitive function in association with hypothalamic inflammation in obese subjects.…”

The effect of overweight/obesity on cognitive function in euthymic individuals with bipolar disorder

“…Based on these previous findings, it may be inferred that BMI contributes to decreased cognitive functioning in euthymic individuals with BD. It is well established that impairments in executive function are apparent in mixed populations of individuals with BD as well as obese individuals without psychiatric disorders [7,10,16,19,22,26,27,28,41,45]. It could be hypothesized that obesity and BD are associated with common central nervous system structural and/ or functional changes in brain regions that subserve cognitive functioning.…”

“…Emerging evidence also indicates that obesity is associated with reduced cognitive function in otherwise healthy individuals [6,10,11,14,16,19,23,39]. The association between anthropometrics and cognitive deficits is detectable in individuals without obesityassociated co-morbidities (e.g.…”

“…A bi-directional relationship between obesity and cognitive function is suggested by studies reporting that individuals with impairment in executive function are more likely to become overweight or obese, perhaps related to disturbances in impulse control, self-monitoring, and goal-directed behaviour [24]. It is further hypothesized that cognitive abnormalities observed in overweight/obese individuals are the expression of abnormalities in brain structure and function [11,16,36]. It has been amply documented that individuals with BD are differentially associated with overweight/obesity and abdominal obesity, and excess weight adversely effects illness presentation, course and outcome; however, to our knowledge, no published study has primarily examined the association between overweight/obesity and cognitive function in adults with BD [15].…”

Obesity and Systemic Inflammation: Insights into Epigenetic Mechanisms

“…Indeed, subclinical inflammation seems to be involved in the pathogenesis of cognitive impairment. Increased body mass and obesity have been related to cognitive decline, including decreased attentional performance, speed of processing and executive functions (Gunstad et al, 2007;Boeka et al, 2008;Fergenbaum et al, 2009). Moreover, midlife obesity is increasingly being described as a dementia risk factor in later life (Fitzpatrick et al, 2009).…”