The relationship between physical activity, sedentary time, and cognitive function following bariatric surgery.

Abstract

Background: Obesity is associated with cognitive impairment. Metabolic and bariatric surgery (MBS) improves cognitive functioning and weight loss is not a primary mechanism. Physical activity (PA) and sedentary time (ST) may play an important role in cognitive outcomes following MBS, though few studies have examined this possibility.

Objectives: Prospectively examine the relationship among PA, ST, and cognitive function following MBS, as well as possible sex differences in these associations.

Setting: Data were collected at 2 health centers in the United States.

Methods: MBS patients (n = 138, 42.9 ± 10.5 years of age, body mass index of 46.3 ± 7.3 kg/m²) completed the National Institute of Health Toolbox, a computerized neuropsychological battery, and wore an accelerometer for 7 days at preoperative baseline and 1, 6, and 12-month postoperative follow-up to measure ST, light-intensity PA (LPA), and moderate-to-vigorous intensity PA (MVPA).

Results: Total attrition rate was 33.3%. Multilevel modeling showed that ST was negatively associated with List Sorting Working Memory (β_0j=-.02,t(379.77)=-3.89,p<.001,95%CI=[-.03,-.01],d=0.26) and Picture Sequence Memory (β_0j=-.02,t(337.93)=-.02,p=.009,95%CI=[-.03,-.004],d=0.47), and positively associated with Flanker Inhibitory Control and Attention (β_0j=.02,t(378.56)=2.89,p=.004,95%CI=[.005,.025],d=0.22). MVPA was positively associated with Card Sort (β_0j=.10,t(139.02)=2.79,p=.006,95%CI=[.03,.17],d=0.58). No significant relationships were found between LPA and cognitive function, and no sex differences were found in any associations.

Conclusions: The current study links ST and MVPA to cognitive function, though ST was both positively and negatively associated with test performance. Such findings suggest a role for movement and activity levels in cognitive outcomes following MBS, though further investigation is needed to clarify possible mechanisms.