The effect of obesity on cognition in adults with and without a mood disorder

Abstract

Obesity is a common medical illness that is known to confer risk for a large number of medical illnesses, such as Type II Diabetes, hypertension, cancer, and late-life dementia. More recently, the relation between obesity and decline in cognitive performance, independent of other comorbid medical conditions, has begun to be examined. Individuals with mood disorders (Bipolar Disorder [BD] or Major Depressive Disorder [MDD]) display an increased prevalence of both obesity and risk factors for cardiovascular disease. Moreover, BD and MDD are associated with impairment in cognitive functioning across multiple domains. The contribution of obesity to cognitive decline in this population has not been explored. This thesis begins with a systematic review of the literature examining the impact of obesity on cognition, providing a thorough background of this relation. The following chapter introduces a prospective cohort study designed to comprehensively explore the relation between obesity and cognition in individuals both with, or without, a mood disorder. The first of set of results from this study are presented in the remaining chapters. The neuropsychological study findings indicate that MDD and obesity may have an additive effect on cognition, resulting in significant cognitive decline in obese adults with MDD. Moreover, we show that different neural activation patterns are seen during a cognitive magnetic resonance imaging (MRI) task in obese versus obese MDD patients. Collectively, this provides strong evidence that populations already at risk for cognitive impairment, such as mood disorder populations, are susceptible to further cognitive changes due to increased weight.