Exploring The Impact of Bariatric Surgery on Cognitive Function

Unveiling the mind-body connection

The older you get, the more likely you are to fear dementia. While Australians of all ages list cancer and dementia as their most-feared diseases, there’s a significant age split. Under-65s put cancer first; over-65s see dementia as more frightening.

Dementia leads to declining thinking, memory, behaviour and mood. You can’t control risk factors like your age and genetics but there are many other ways to reduce your risk of dementia, including quitting smoking, limiting alcohol, eating a healthy diet, staying fit, sleeping well and giving your brain a regular workout with puzzles, games, craft or music.

So how does your weight affect your brain? Quite a lot, according to new research.

Obesity And Cognitive Decline: Does Bariatric Surgery Help?

Obesity is recognised as an independent risk factor for cognitive decline. Recently Iranian researchers found that bariatric surgery led to measurable cognitive improvements in older adults.

To meet the study criteria, the research participants had to:

• Be over 60
• Have a BMI
  • above 40
  • above 35 plus at least 1 obesity-related condition like diabetes, fatty liver disease, sleep apnoea, high cholesterol, degenerative joint disease, gastrointestinal problems or cardiovascular disorder.

In the end, 73 people completed the study. All completed validated tests of their cognitive function at the start and end of the study. Some patients (24 in total) had bariatric surgery during the study (the active treatment group). Most had a Roux-en-Y gastric bypass while the rest had gastric sleeve. The rest of the patients (49) remained in the control group and did not have bariatric surgery during the study.

At baseline (the start of the study), the participants in the active and control groups were similar in terms of their age, gender and educational level. Those in the surgery group were a little heavier with an average BMI of 41.2 compared to 39.8.

Unsurprisingly given their similarities the two groups gained very similar scores on their baseline cognitive tests, which measured 4 key aspects of cognitive function: attention, working memory, processing speed and executive functioning.

But the second set of test scores showed key differences between the two groups. Those who had had bariatric surgery since completing the first set of tests showed significant improvements in their cognitive function while the control group’s scores stayed the same.

How Does Bariatric Surgery Improve Cognitive Function?

The researchers suggest several explanations for how bariatric surgery could improve cognitive function.

Bariatric surgery may improve cognitive function by improving:

• Physical health: Weight loss surgery often improves comorbid medical conditions like diabetes, high cholesterol or sleep apnoea, corrects systemic inflammation and improves neurohormones.
• Social interactions and mental health: A more active and engaged life may enhance cognitive abilities, especially for older adults.

Are There Any Limitations To The Study?

Of course – all studies have some limitations. This was an observational study rather than a randomised controlled trial. It also had a short follow-up period of only 4 months and it did not look at other cognitive domains like memory and language.

Despite those limitations, it still shows that bariatric surgery leads to meaningful cognitive advantages in older people and may be a way of preventing some neurodegenerative disorders.

What Can You Do?

If you’re overweight and under 60, take note! Obesity is associated with numerous adverse health outcomes that affect your physical, mental, emotional and cognitive health. To maintain your quality of life as you age, do what you can to lose those kilos.

How Can Dr Lockie Help?

If you’d like to explore how bariatric surgery could help you, we’d love to share our expertise.

Dr Lockie is a highly experienced weight loss surgeon with an excellent track record.

He leads a multidisciplinary approach to weight loss, believing that behavioural, dietary, psychological, physical and medical considerations all play a role in achieving and sustaining a healthy weight.

Feel free to book an appointment today if you would like to explore your options.

Disclaimer

All information is general and is not intended to be a substitute for professional medical advice. Dr Phil Lockie can consult with you to confirm if a particular procedure or treatment is right for you. All surgery carries risks.

References

• Watson R, Sanson-Fisher R, Bryant J, Mansfield E. Dementia is the second most feared condition among Australian health service consumers: results of a cross-sectional survey. BMC Public Health. 2023 May 12;23(1):876. doi: 10.1186/s12889-023-15772-y. PMID: 37173717; PMCID: PMC10176813. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176813/, [Accessed 27 May 2024]
• Dementia Australia, Reducing your risk of dementia, https://www.dementia.org.au/brain-health/reducing-your-risk-dementia, [Accessed 27 May 2024]
• Shariati, B et al, Effects of bariatric surgery on cognitive function in older adults: a prospective longitudinal study, Surgery for Obesity and Related Diseases, Vol 19, Issue 11, p1265-1269, November 2023, https://doi.org/10.1016/j.soard.2023.04.336, [Accessed 27 May 2024]