Physical activity and cognitive function in bariatric surgery candidates

Abstract

Cognitive impairment is common in severe obesity. Lack of physical activity is a likely contributor to impairment in this population, as many obese persons are inactive and physical activity has been positively and independently associated with cognitive function in healthy and medically-ill samples. This study investigated whether physical activity, measured by self-report of aerobic physical activity in 85 bariatric surgery candidates, was associated with cognitive function. A subset of 31 participants also completed objective activity monitoring. Steps/d and high-cadence min/week, representative of ambulatory moderate to vigorous physical activity (MVPA), were calculated. Approximately one quarter of participants self-reported at least 30 min/d of aerobic MVPA, at least 5 d/week. Median steps/d was 7949 (IQR = 4572) and median MVPA min/week was 105 (IQR = 123). Cognitive deficits were found in 32% of participants (29% memory, 10% executive function, 13% language, 10% attention). Controlling for demographic and medical factors, self-reported aerobic physical activity was weakly correlated with lower attention (r = -0.21, p = 0.04) and executive function (r = -0.27, p < 0.01) and both self-reported aerobic physical activity and objectively-determined MVPA min/week were negatively correlated with memory (r = -0.20, p = 0.04; r = -0.46; p = 0.02, respectively). No other correlations between physical activity measures and cognitive function were significant. Contrary to expectations, greater levels of physical activity were not associated with better cognitive functioning. Such findings encourage future studies to clarify the association among cognitive function and physical activity in obese persons.

Physical Activity, Decision-Making Abilities, and Eating Disturbances in Pre- and Postbariatric Surgery Patients

“…The lack of associations between PA and executive function (i.e., decision-making) is in line with the results of Galioto et al [13] who also failed to find significant correlations between executive function and objectively measured PA in preoperative bariatric surgery patients. We agree with Galioto et al that the most likely explanation for the missing relationship is the low level of PA in bariatric surgery patients.…”

“…Galioto et al [13] investigated attention, executive functions, memory, and verbal fluency in 31 candidates for bariatric surgery with a standardized cognitive test battery. The patients also wore an activity monitor to objectively measure PA.…”

Combined Effects of Physical Activity and Obesity on Cognitive Function: Independent, Overlapping, Moderator, and Mediator Models

“…Results indicated that both physical activity programs benefitted inhibition; however, overweight children, compared with lean children, had larger improvements in inhibition in the enhanced physical education program. Thus, this study also supported the role of obesity status as a moderator of the effects of physical activity on cognitive function, but in contrast to other research [46,48] this study reported greater cognitive benefits for the overweight group.…”

“…In a study of college students, the positive relation between more self-reported physical activity and better inhibitory control, sustained attention, and vigilance was observed in lean (BMI 18.5-24.9 kg/m 2 ) but not in obese (BMI > 30 kg/m 2 ) participants [46]. Galioto et al [48] examined the correlation between physical activity and cognitive function in morbidly obese individuals eligible for bariatric surgery, where analyses were conducted for the full group (i.e., average BMI 46.8 kg/m 2 ) and for the subgroup of even more obese individuals (i.e., average BMI 48.6 kg/m 2 ). The results revealed a weak correlation between self-reported physical activity and cognition (e.g., executive function, attention, memory) after adjustments for BMI in the full group; however, no correlation between objectively reported physical activity and cognition was observed when examining the even more obese subgroup.…”

“…2d). One study employing a RCT design [45] and four studies employing cross-sectional designs [46,47,48,49] are categorized as testing hypothesis 4.…”