Cognitive Effects of Intentional Weight Loss in Elderly Obese Individuals With Mild Cognitive Impairment

Author(s):Show less -

Horie, Nidia Celeste ^[1] ; Serrao, Valeria T. ^[2] ; Simon, Sharon Sanz ^[3] ; Polo Gascon, Maria Rita ^[2] ; dos Santos, Alessandra Xavier ^[4] ; Zambone, Maria Aquimara ^[4] ; del Bigio de Freitas, Marta Merenciana ^[5] ; Cunha-Neto, Edecio ^[6] ; Marques, Emerson Leonildo ^[1] ; Halpern, Alfredo ^[1] ; de Melo, Maria Edna ^[1] ; Mancini, Marcio C. ^[1] ; Cercato, Cintia ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Med, Obes & Metab Syndrome Grp, BR-01246903 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Hosp Clin, Psychol Div, BR-01246903 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, Inst Psychiat, BR-01246903 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Med, Clin Hosp, Div Nutr, BR-01246903 Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Med, Discipline Geriatr, BR-01246903 Sao Paulo - Brazil

^[6] Univ Sao Paulo, Sch Med, Div Clin Immunol & Allergy, BR-01246903 Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM; v. 101, n. 3, p. 1104-1112, MAR 2016.
• Web of Science Citations: 33

Abstract

Context: Obesity in midlife is a risk factor for dementia, but it is unknown if caloric restriction-induced weight loss could prevent cognitive decline and therefore dementia in elderly patients with cognitive impairment. Objective: To evaluate the cognitive effect of intentional weight loss in obese elderly patients with mild cognitive impairment (MCI), considering the influence of age, apolipoprotein E (APOE) genotype, physical activity, biochemical markers, and diet. Design: Single-center, prospective controlled trial. Setting: Academic medical center. Participants: Eighty obese patients with MCI, aged 60 or older (68.1 +/- 4.9 y, body mass index {[}BMI] 35.5 +/- 4.4 kg/m(2), 83.7% women, 26.3% APOE allele epsilon 4 carriers). Intervention: Random allocation to conventional medical care alone (n = 40) or together with nutritional counselling (n = 40) in group meetings aiming to promote weight loss through caloric restriction for 12 months. Outcome Measurements: clinical data, body composition, neuropsychological tests (main outcome), serum biomarkers, APOE genotype, physical performance, dietary recalls. Results: Seventy-five patients completed the follow-up. BMI, on average, decreased 1.7 +/- 1.8kg/m(2) (P = .021), and most of the cognitive tests improved, without difference between the groups. In analysis with linear generalized models, the BMI decrease was associated with improvements in verbal memory, verbal fluency, executive function, and global cognition, after adjustment for education, gender, physical activity, and baseline tests. This association was strongest in younger seniors (for memory and fluency) and in APOE allele epsilon 4 carriers (for executive function). Changes in homeostasis model assessment-estimated insulin resistance, C-reactive protein, leptin and intake of energy, carbohydrates, and fats were associated with improvement in cognitive tests. Conclusions: Intentional weight loss through diet was associated with cognitive improvement in patients with MCI. (AU)

• FAPESP's process: 11/06194-6 - Caloric restriction in obese patients with mild cognitive impairment: effects on adiposity, comorbidity and cognition
• Grantee: Cintia Cercato
• Support Opportunities: Regular Research Grants