Journal
SURGERY FOR OBESITY AND RELATED DISEASES
Volume 18, Issue 11, Pages 1323-1338Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.soard.2022.07.007
Keywords
Obesity; Bariatric surgery; Cognition; Memory; Meta-analysis
Categories
Funding
- National Natural Science Foundation of China [8210033261]
- Natural Science Foundation of Shandong Province [ZR2019MC046]
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The study found that Roux-en-Y gastric bypass surgery has a positive impact on cognition in patients with severe obesity, particularly improving immediate and delayed memory function in both short-term and long-term.
Obesity impairs cognition. Bariatric surgery can result in substantial weight loss in patients with severe obesity; however, the impact of bariatric surgery on cognitive function remains controversial. To quantify the effect of bariatric surgery on cognition in patients with severe obesity, we performed a meta-analysis of 20 studies retrieved from PubMed, Cochrane, and Embase. Of these, 6 cohort studies found that Roux-en-Y gastric bypass leads to better performance for immediate verbal memory function (standardized mean difference [SMD] = .56; 95% confidence interval [CI]: .30-.82, P < .0001; I2 = 0%) and delayed memory function (SMD = .64; 95% CI: .38-.90, P < .00001; I-2 = 0%) during in the short term. Similarly, positive impacts on immediate verbal memory function (SMD = .46; 95% CI: .09-.83, P < .00001) and delayed memory function (SMD = .84; 95% CI: .46-1.22, P < .0001) were identified during a long-term follow-up. The Roux-en-Y gastric bypass group showed no improvements in attention, cognitive speed, and executive function compared with the control obese group. In 14 longitudinal studies (12 single-arm pre-post comparison studies and 2 cohort studies whose control group had no follow-up cognitive data), patients performed better postoperatively than preoperatively in all cognitive domains during repeated assessments. The analysis for the 20 operative groups showed that individuals treated with bariatric surgery had higher scores after repeated assessment of most neuropsychological tests except for animal fluency and letter fluency than baseline scores. These findings suggest that patients with severe obesity may obtain immediate verbal and delayed memory function benefits from Roux-en-Y gastric bypass. (C) 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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