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J Clin Psychiatry. 2017 Sep/Oct;78(8):e924-e932. doi: 10.4088/JCP.16m10968.

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

Author information

1
Psychiatric Service, Hospital Universitari Santa Maria, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Catalonia, Spain.
2
Child and Adolescent Mental Health Centre, Sant Joan de Déu Lleida, Catalonia, Spain.
3
Department of Psychiatry, Hospital de Santa Creu i Sant Pau, Autonomous University of Barcelona, St. Antoni M. Claret, 167, 08025 Barcelona, Catalonia, Spain. mportella@santpau.cat.
4
Psychiatric Service, Research Institute, Hospital de Santa Creu i Sant Pau, Autonomous University of Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
5
Biostatistics Unit, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Catalonia, Spain.
6
Bipolar Disorder Program, Hospital Clinic, Institute of Neuroscience, University of Barcelona, L'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain.
7
Department of Psychiatry, Hospital Santa Maria de Lleida, University of Lleida, Alcalde Rovira Roure Ave, 80, 25198 Lleida, Catalonia, Spain. mmur@gss.scs.es.

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.

PMID:
28994517
DOI:
10.4088/JCP.16m10968
[Indexed for MEDLINE]

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