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Introduction: Obesity is associated with cognitive impairment, and bariatric surgery has been shown to improve cognitive functioning. Rapid improvements in glycemic control are common after bariatric surgery and likely contribute to these cognitive gains. We examined whether improvements in glucose regulation are associated with better cognitive function following bariatric surgery. Method: A total of 85 adult bariatric surgery patients underwent computerized cognitive testing and fasting blood draw for glucose, insulin, and glycated hemoglobin (HbA1c) at baseline and 12 months postoperatively. Results: Significant improvements in both cognitive function and glycemic control were observed among patients. After controlling for baseline factors, 12-month homeostatic model assessment of insulin resistance HOMA-IR predicted 12-month digits backward (β = –.253, p <.05), switching of attention–A (β =.156, p <.05), and switching of attention–B (β = –.181, p <.05). Specifically, as HOMA-IR decreased over time, working memory, psychomotor speed, and cognitive flexibility improved. Decreases in HbA1c were not associated with postoperative cognitive improvements. After controlling for baseline cognitive test performance, changes in body mass index (BMI) were also not associated with 12-month cognitive function. Conclusions: Small effects of improved glycemic control on improved aspects of attention and executive function were observed following bariatric surgery among severely obese individuals. Future research is needed to identify the underlying mechanisms for the neurocognitive benefits of these procedures. [ABSTRACT FROM AUTHOR]

Introduction: Treatment nonadherence is common in heart failure (HF) and is associated with poor health outcomes in this population. Recent cross-sectional work in heart failure and past work in other medical populations suggest that cognitive function is a key determinant of a patient’s ability to adhere to treatment recommendations. However, it is also possible that treatment adherence is an important modifier and predictor of cognitive function, though no study has examined this possibility, and we sought to do so in a sample of heart failure patients.Method: A total of 115 patients with heart failure self-reported adherence to treatment recommendations. The Modified Mini Mental State Examination (3MS), Trail Making Test Parts A and B, and the California Verbal Learning Test–II (CVLT–II) assessed cognitive function. These procedures were performed at baseline and a 12-month follow-up.Results:Global cognition and memory abilities improved over the 12-month period. Regression analyses controlling for baseline and medical and demographic factors showed that better baseline treatment adherence predicted improved 12-month performances on the 3MS and CVLT–II. Adherence to medication and diet regimens and smoking abstinence emerged as the most important contributors.Conclusions:Better treatment adherence predicted improved cognition one year later in HF. Prospective studies that utilize objective assessments of treatment adherence are needed to confirm our findings and examine whether improved treatment adherence preserves cognitive function in heart failure. [ABSTRACT FROM PUBLISHER]

Obesity is an established risk factor for cognitive impairment. Theories of cognitive reserve suggest that premorbid factors, such as intellectual ability, may attenuate the expression of cognitive impairment due to age or disease. The current study examined whether cognitive reserve, defined as estimated premorbid intellectual ability, moderates the relationship between obesity and cognitive function in obese adults. Participants without major medical or psychological conditions completed a computerized battery of neuropsychological tests. Hierarchical regression models found a significant interaction between BMI and cognitive reserve for attention/executive function and memory, suggesting that cognitive reserve attenuates the expression of obesity-related cognitive impairment. [ABSTRACT FROM AUTHOR]