This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.


The Impact of Obesity on Cognitive Functioning in Euthymic Bipolar Patients: A Cross-Sectional and Longitudinal Study

Ester Mora, MD, PhD; Maria J. Portella, PhD; Montserrat Martinez-Alonso, PhD; Montse Teres, DClinPsy; Irene Forcada, MD, PhD; Eduard Vieta, MD, PhD; and Maria Mur, MD, PhD

Published: October 3, 2017

Article Abstract

Objective: To determine the influence of body mass index (BMI) on cognition in euthymic bipolar patients and healthy matched controls in a post hoc study of 2 cross-sectional and longitudinal exploratory studies.

Method: A total sample of 121 individuals was examined, which included 52 euthymic bipolar disorder I or II patients (DSM-IV-TR criteria) and 69 healthy controls matched by age and gender, categorized in 2 subgroups in terms of body mass index (BMI-factor): normal weight (BMI: 18.5-24.9 kg/m2) versus overweight-obesity (overweight, BMI: 25.0-29.9 kg/m2; and obese, BMI ≥ 30 kg/m2). Demographic, clinical, cognitive, and psychosocial functioning data were collected from 2003 until 2011. Cognitive domains studied were executive function, attention, processing speed, verbal memory, and visual memory. Fifty-four subjects (28 bipolar and 26 healthy controls) were reevaluated after 6 years of follow-up.

Results: Obesity and bipolar disorder showed a significant effect on cognition in cross-sectional and long-term MANOVA analyses (F7,111 = 2.54, P = .018 and F19,23 = 2.25, P = .033, respectively). In the cross-sectional linear regression model, global cognitive functioning was predicted by the interaction of BMI-factor by group (β = −0.44, SE = 0.14, P = .002), current age (β = −0.44, P < .0001), and premorbid IQ (β = 0.28, P = .0002), which explained 56% of variance (F5,115 = 29.6, P < .0001). Change in cognitive functioning over time was predicted by the interaction of BMI-factor by group (β = −0.8, SE = 0.33, P = .022) and cognition at baseline (β = −0.46, SE = 0.15, P = .004), which explained 27.65% of variance (F6,40 = 2.548, P = .0349). Generalized estimating equations analysis showed that interaction of group by BMI (Wald χ21 = 5.37, P = .02), age (Wald χ21 = 22.08, P < .0001), and premorbid IQ (Wald χ21 = 25.65, P < .0001) were the significant predictors.

Conclusions: Obesity was significantly associated with cognitive impairment in euthymic bipolar patients, and it also appeared to affect cognition in the long term.

Volume: 78

Quick Links:

Continue Reading…

Subscribe to read the entire article


Buy this Article as a PDF