Obesity, IGT, T2DM and Cognitive Function

Question 1

How does memory change with age?

Answer 1

• Slight decline in non-declarative memory
• Problems with episodic memory are most common in MCI and early-stage Alzheimer’s disease
• Decline in prospective memory is common
• Rare to lose procedural memory

Question 2

What is MCI?

Answer 2

• Normal general cognitive performance
• No dementia according to clinical criteria
• Normal activities of daily living
• BUT Subjective memory complaint

Question 3

Obese adults perform worse than normal weight adults on what?

Answer 3

• Learning & Memory (List learning, Delayed recall, Recognition)
• Frontal lobe tasks (Executive Function, Complex attention, Psychomotor speed)

Question 4

Obese adults perform better than normal weight adults on?

Answer 4

attention and visuospatial abilities

Question 5

What were the 4 findings of Elias from the Framington data about obesity and cog function?

Answer 5

1. Effects of Obesity & HT on learning & memory in men not women.
2. Indpt of other CVD risk.
3. Suggest similar patho-physiological mechanisms.
4. Are cummulative (men) – presence of O & HT – more cog deficits than either/none

Question 6

How is wait-hip-ratio related to hippocampal volume?

Answer 6

• When adjust for age – hippocampal volume is lower higher w-h-r individual
• Argument that increased viseral fat may induce cog decline

Question 7

What are some gender differences in response to chronic stress?

Answer 7

• Women: lower adiposity, greater CV responses to acute stress, better cognitive performance
• Men: Greater adiposity, Lower CV response to acute stress

Question 8

T2DM is associated with what?

Answer 8

• Accelerated rate of cognitive ageing
• Reduced hippocampal volume – memory
• BUT… confounded by cognitive effects of ageing

Question 9

What cognitive impairments are associated with T2DM?

Answer 9

o Verbal memory,
o Spatial memory,
o Psychomotor skill,
o Executive function

Question 10

What is the effect of IGT on glycaemic response?

Answer 10

• People with IGT – greater interference – number of words forgotten in verbal memory test was greater later in the day

Question 11

What is the effect of IGT on memory?

Answer 11

• IGT greater retroactive interference at Session 2 relative to Session 1
• IGT poorer delayed recall & recognition of verbal material - deficit in hippocampal function

Question 12

What does bariatric surgery change (cognition)?

Answer 12

• Sig rapid weight loss associated with Rapid improvement in:
  o Memory
  o Executive function
  o Cognitive Control

Question 13

What may be the causal factors of obesity and cognition?

Answer 13

• gluco-regulation, insulin resistance, & other factors

Question 14

decreased glucose utilisation can lead to?

Answer 14

Insulin resistance

Question 15

What are 2 risk factors for cog complications in diabetes?

Answer 15

• degree of metabolic control

- repeated episodes of hypoglycaemia