title: Lower cognitive functioning as a predictor of weight gain in bipolar disorder: a 12-month study.
abstract: OBJECTIVE
  In cross-sectional studies, elevated body mass index (BMI) is associated with cognitive impairment in bipolar disorder (BD). We investigated the direction of this association by prospectively examining changes in BMI and cognition.
  
  
  METHODS
  We measured BMI and performance in six cognitive domains over 12 months in 80 adolescent and young adult BD patients and 46 healthy comparison subjects (HS). Ninety-three percent of patients received pharmacotherapy and 84% were euthymic. We used repeated-measures ancova and longitudinal mixed models to investigate whether (i) higher BMI and increasing BMI over time predicted lower subsequent cognitive functioning, and (ii) lower cognitive functioning and changes in cognition predicted increasing BMI.
  
  
  RESULTS
  Neither baseline BMI nor BMI change predicted lower cognitive functioning. Lower baseline scores in attention, verbal memory, working memory, and a composite measure of global cognition predicted increasing BMI in patients and HS. In patients, lower cognitive functioning remained associated with increasing BMI when clinical and treatment variables were adjusted for. Improvement in working memory predicted a smaller subsequent BMI increase in patients.
  
  
  CONCLUSIONS
  Lower cognitive functioning in specific domains predicts increasing BMI in patients with BD and healthy young adults. Targeting cognition may be important for minimizing weight gain in BD.
authors.affiliation: Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada.|Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Bond
authors.affiliation: Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada.
authors.forename: I J
authors.initials: IJ
authors.lastname: Torres
authors.affiliation: Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada.
authors.forename: J-M
authors.initials: JM
authors.lastname: Kozicky
authors.affiliation: Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: L E
authors.initials: LE
authors.lastname: Silveira
authors.affiliation: Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Dhanoa
authors.affiliation: Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada.
authors.forename: R W
authors.initials: RW
authors.lastname: Lam
authors.affiliation: Mood Disorders Centre, University of British Columbia, Vancouver, BC, Canada.
authors.forename: L N
authors.initials: LN
authors.lastname: Yatham
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D015430:Weight Gain; D055815:Young Adult
keywords: bipolar disorder; cognition; obesity; weight gain