title: Adolescent weight history and adult cognition: before and after bariatric surgery.
abstract: BACKGROUND
  Cognitive deficits occur in a subset of individuals with obesity. Deficits can be reversed with bariatric surgery, though cognitive recovery is not equally exhibited across patients. Recent work has found that obesity during adolescence portends medical complications in adulthood; it is unknown if obesity in adolescence predicts adult cognition or cognitive recovery after weight loss surgery.
  
  
  OBJECTIVE
  The present study examines the relationship between weight history and cognitive function in obese adults undergoing bariatric surgery.
  
  
  METHODS
  Academic medical centers with bariatric care services.
  
  
  METHODS
  Seventy-eight bariatric surgery patients (mean age = 43.2 years) enrolled in an ancillary study to the Longitudinal Assessment of Bariatric Surgery (LABS) project completed a questionnaire recalling weight history at age 18. Cognitive testing was completed preoperatively and at 12-month follow-up.
  
  
  RESULTS
  Weight status at age 18 was linked to performance in several aspects of cognition. Higher body mass index at age 18 predicted poorer preoperative verbal fluency (B = -.26, P = .045) as well as postoperative cognitive recovery in attention (B = -.30, P = .01) at 12-month follow-up.
  
  
  CONCLUSIONS
  Higher body mass index at age 18 predicts verbal fluency performance in adults with obesity, as well as postoperative recovery of attention after bariatric surgery. The mechanisms underlying this connection are not fully clear, though findings may reflect effects of obesity on the brain during a crucial period of neural maturation or duration of obesity and cumulative impact of co-morbidities on cognition. Future work examining possible causal factors involved in these relationships is needed.
authors.affiliation: Kent State University, Kent, Ohio; Summa Health System, Akron, Ohio. Electronic address: mspitzna@kent.edu.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.affiliation: Kent State University, Kent, Ohio.
authors.forename: Michael
authors.initials: M
authors.lastname: Alosco
authors.affiliation: Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
authors.affiliation: Kent State University, Kent, Ohio.
authors.forename: Amber
authors.initials: A
authors.lastname: Rochette
authors.affiliation: Weill Cornell Medical College, New York, New York.
authors.forename: Gladys
authors.initials: G
authors.lastname: Strain
authors.affiliation: Columbia University College of Physicians & Surgeons, New York, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Devlin
authors.affiliation: Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.affiliation: Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.affiliation: Kent State University, Kent, Ohio; Summa Health System, Akron, Ohio.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D050110:Bariatric Surgery; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009765:Obesity / Q000523:psychology* / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D014705:Verbal Behavior / Q000502:physiology
keywords: Bariatric; Cognition; Obesity; Weight history