Abstract:
Background: Prior research reports decreased multi-domain cognition following significant weight gain and both increased and decreased cognitive performance, with a focus on memory, following bariatric surgery. These inconsistent data leave room for further exploration of the issue of post-operative cognitive change in Metabolic Bariatric Surgery (MBS) patients.
Objectives: To explore cognitive performance changes in Sleeve Gastrectomy (SG) patients 12 months postoperatively compared to preoperative baseline. To understand any potential implications/advantages from rapid weight loss on memory/cognition.
Methods: Pre- and 12m postoperative Sleeve Gastrectomy (SG), participants (N=20) from the Metabolic Bariatric Surgery program, approved for surgery, were assessed using the California Verbal Learning Test (CVLT) and in multiple cognitive domains using the CogState Online Testing Battery. The latter included a variety of visual and verbal tasks, e.g the Groton Maze Task, One back and Two back learning, and Continuous Paired Association. Missing endpoint data (N=10) were interpolated using the MICE method in R with predictor variables including gender, age, education, and weight. Paired t-tests assessed initial score differences between timepoints for each CogState subtest of interest, and supplementary analysis was done with a linear mixed methods approach.
Results: At an α level of 0.05, uncorrected for multiple comparisons, no cognitive measure showed a statistically significant change pre- vs post-operatively. Findings were unaltered following interpolation for missing values. Additionally, no performance trend was discernible. The mixed effects model used to examine covariates found no significant main effects.
Conclusion: The results showed no replication of previous research in bariatric patients reporting either significant MBS post-operative cognitive increases or decreases. Both the CVLT and CogState battery that were utilized are widely-used, well-normed assessment tools. Although these measures did not return significant results, future investigations can make use of a larger sample, and incorporate more diverse measures to assess other dimensions of cognition and their improvement or decline in relation to SG.
Audience take away notes:
- Understanding the need for higher level analysis for memory and cognition performance in bariatric surgery patients.
- Identifying specific domains of cognition to further study.
- Better understanding the necessary sample size for statistical significance in measuring cognition for this population
- Contributing to a precedent of researching obesity as a condition that impacts the brain
- Understanding possible cognitive advantages/implications following Metabolic Bariatric Surgery.
