Cognitive Impairment, Obesity, and the Effects of Bariatric Surgery

Study Overview
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Brief Summary
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Study is designed to screen psychological cognitive baseline and retention/improvement after weight loss surgery.

Detailed Description
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Patients with morbid obesity have shown to be at increased risk for memory loss and cognitive decline. Obesity and high-fat diets have been associated with deficits in learning, memory, and executive functioning. Bariatric surgery results in significant weight loss for patients and helps resolve obesity-related comorbidities such as diabetes and high blood pressure. Interestingly, bariatric surgery has shown promise in improving some aspects of cognitive function and improved memory. (3-1) Obesity affects brain structure, more specifically the grey and white matter, likely in part by reducing oxygen flow to the various regions in the brain. Studies have shown a correlation between BMI and cerebral blood flow velocity (CBFV), where higher BMI is associated with lower CBFV. Although it is not clear how exactly obesity plays a role in the brain's structural and functional changes, observations revealed compromised grey and white matter integrity, its fiber connectivity or cortical atrophy and metabolic alterations. (2) Few studies exist on the impact of bariatric surgery on cognition. Some studies have shown that patients with obesity who underwent bariatric surgery had memory and cognitive improvement compared to those who had not undergone surgery. (4) Thus, the investigators hope to add to our understanding of how bariatric surgery can improve cognitive decline and to potentially offer surgery to more patients with baseline cognitive impairment and to improve cognitive function overall for patients with obesity. More longitudinal studies need to be done to connect bariatric surgery effects with cognitive decline, specifically memory.

Official Title
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Cognitive Impairment, Obesity, and the Effects of Bariatric Surgery

Conditions
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Obesity, Morbid, Bariatric Surgery Candidate

Intervention / Treatment
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* Behavioral: Surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cognitive impairment/decline, memory impairment/loss, or Alzheimer's disease or dementia and bariatric surgery • Cognitive impairment/decline, memory impairment/loss, or Alzheimer's disease or dementia and obesity, and no bariatric surgery history Exclusion Criteria: Patients without a history of memory impairment/loss, bariatric surgery, or obesity Patients outside of University of California Davis Health System Patients unable to provide consent

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Surgery<br>Patients scheduled for or have already completed Weight Loss Surgery at UC Davis Medical Center | Behavioral: Surgery<br>* Study subjects scheduled for or have already completed weight loss surgery and have already completed psychological screening as part of their pre-surgery work up<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| California Verbal Learning Test-3rd Edition (CVLT-3) | Measures episodic verbal learning including Verbal Learning, immediate memory, and delayed memory | Pre-operatively | 
| California Verbal Learning Test-3rd Edition (CVLT-3) | Measures episodic verbal learning including Verbal Learning, immediate memory, and delayed memory | 12 Months after index screening/date of surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brief Visuospatial Memory Test | Measures visuospatial learning and memory, including visual learning, immediate memory, and delayed memory. | Pre-operatively and 12 months after index screening/date of surgery | 
| Brief Visuospatial Memory Test | Measures visuospatial learning and memory, including visual learning, immediate memory, and delayed memory. | Pre-operatively | 
| Trial Making Test, A & B | Measures visual spatial attention, motor speed and cognitive flexibility | 12 months after index screening/date of surgery | 
| WAIS-IV Digit Span Forward & Backward | Measures auditory Attention (Forward), and Auditory attention and working memory (Backward) | Pre-Operatively | 
| WAIS-IV Digit Span Forward & Backward | Measures auditory Attention (Forward), and Auditory attention and working memory (Backward) | 12 months after Index screening/date of surgery | 
| Verbal Fluency, Phonemic & Semantic | Measures verbal fluency by a word generation task based on letter & category (executive functioning) | Pre-operatively | 
| Verbal Fluency, Phonemic & Semantic | Measures verbal fluency by a word generation task based on letter & category (executive functioning) | 12 months after index screening/date of surgery | 
| Stroop Color and Word Test; Word, Color & Word-Color | Measures reading speed (word), naming speed (processing) and selective attention and inhibition (attention/executive functioning) | Pre-Operatively | 
| Stroop Color and Word Test; Word, Color & Word-Color | Measures reading speed (word), naming speed (processing) and selective attention and inhibition (attention/executive functioning) | 12 months after index screening/date of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obesity, Bariatric Surgery, Cognitive Screening