Obesity and post-operative cognitive dysfunction: a systematic review and meta-analysis

Area of Science:

• Medical research
• Neuroscience
• Gerontology

Background:

• Post-operative cognitive dysfunction (POCD) is a significant concern after surgery, linked to dementia and mortality.
• While obesity is a known risk factor for late-life cognitive decline, its specific impact on POCD remains unclear.

Purpose of the Study:

• To systematically review and meta-analyze existing studies on the association between obesity and the risk of developing post-operative cognitive dysfunction.

Main Methods:

• A systematic search of PubMed and the Cochrane Library was conducted.
• Included studies were prospective, involved adult surgical patients with pre- and post-surgery cognitive assessments, and reported on obesity metrics (BMI, body weight) and POCD risk (RR or OR).
• Underweight, weight loss, and post-operative delirium were excluded from the analysis.

Main Results:

• Six studies with 1432 patients (mean age ≥62 years) met the inclusion criteria.
• Categorical analysis of obesity (BMI >30 kg/m² vs. ≤30 kg/m²) showed a non-significant trend towards increased POCD risk (RR 1.27; p=0.10).
• Continuous analysis of BMI and body weight did not reveal significant associations with POCD risk.

Conclusions:

• Current evidence offers limited support for an increased risk of post-operative cognitive dysfunction in obese patients.
• Larger, prospective studies are required to definitively clarify the relationship between obesity and POCD.