The relationship between physical activity, sedentary time, and cognitive function following bariatric surgery

Obesity is associated with cognitive impairment. Metabolic and bariatric surgery (MBS) improves cognitive functioning and weight loss is not a primary mechanism. Physical activity (PA) and sedentary time (ST) may play an important role in cognitive outcomes following MBS, though few studies have examined this possibility.

Prospectively examine the relationship among PA, ST, and cognitive function following MBS, as well as possible sex differences in these associations.

Data were collected at 2 health centers in the United States.

MBS patients (n = 138, 42.9 ± 10.5 years of age, body mass index of 46.3 ± 7.3 kg/m²) completed the National Institute of Health Toolbox, a computerized neuropsychological battery, and wore an accelerometer for 7 days at preoperative baseline and 1, 6, and 12-month postoperative follow-up to measure ST, light-intensity PA (LPA), and moderate-to-vigorous intensity PA (MVPA).

Total attrition rate was 33.3%. Multilevel modeling showed that ST was negatively associated with List Sorting Working Memory (β_0j=-.02,t(379.77)=-3.89,p<.001,95%CI=[-.03,-.01],d=0.26) and Picture Sequence Memory (β_0j=-.02,t(337.93)=-.02,p=.009,95%CI=[-.03,-.004],d=0.47), and positively associated with Flanker Inhibitory Control and Attention (β_0j=.02,t(378.56)=2.89,p=.004,95%CI=[.005,.025],d=0.22). MVPA was positively associated with Card Sort (β_0j=.10,t(139.02)=2.79,p=.006,95%CI=[.03,.17],d=0.58). No significant relationships were found between LPA and cognitive function, and no sex differences were found in any associations.

The current study links ST and MVPA to cognitive function, though ST was both positively and negatively associated with test performance. Such findings suggest a role for movement and activity levels in cognitive outcomes following MBS, though further investigation is needed to clarify possible mechanisms.