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Review
. 2015 Jul-Aug;77(6):697-709.
doi: 10.1097/PSY.0000000000000212.

Obesity and Aging: Consequences for Cognition, Brain Structure, and Brain Function

Gérard N Bischof  1 , Denise C Park
Affiliations
Review

Obesity and Aging: Consequences for Cognition, Brain Structure, and Brain Function

Gérard N Bischof et al. Psychosom Med. 2015 Jul-Aug.

Abstract

Objectives: This review focuses on the relationship between obesity and aging and how these interact to affect cognitive function. The topics covered are guided by the Scaffolding Theory of Aging and Cognition (STAC [Park and Reuter-Lorenz. Annu Rev Psychol 2009;60:173-96]-a conceptual model designed to relate brain structure and function to one's level of cognitive ability.

Methods: The initial literature search was focused on normal aging and was guided by the key words, "aging, cognition, and obesity" in PubMed. In a second search, we added key words related to neuropathology including words "Alzheimer's disease," "vascular dementia," and "mild cognitive impairment."

Results: The data suggest that being overweight or obese in midlife may be more detrimental to subsequent age-related cognitive decline than being overweight or obese at later stages of the life span. These effects are likely mediated by the accelerated effects obesity has on the integrity of neural structures, including both gray and white matter. Further epidemiological studies have provided evidence that obesity in midlife is linked to an increased risk for Alzheimer's disease and vascular dementia, most likely via an increased accumulation of Alzheimer's disease pathology.

Conclusions: Although it is clear that obesity negatively affects cognition, more work is needed to better understand how aging plays a role and how brain structure and brain function might mediate the relationship of obesity and age on cognition. Guided by the STAC and the STAC-R models, we provide a roadmap for future investigations of the role of obesity on cognition across the life span.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cross-sectional aging data adapted from Park et al. (2002) showing behavioral performance on measures of processing speed (i.e., Digit Symbol, Letter Comparison, Pattern Comparison), working memory (i.e., Letter Rotation, Line span, Computation Span, Reading Span), Long-Term Memory (i.e., Benton, Rey, Cued Recall, Free Recall), and world knowledge (i.e., Shipley Vocabulary, Antonym Vocabulary, Synonym Vocabulary). Almost all measures of cognitive function showed declines with age, except world knowledge, which showed slight improvements.
Figure 2
Figure 2
A conceptual model of the scaffolding theory of aging and cognition (STAC).
Figure 3
Figure 3
A revision of the scaffolding theory of aging and cognition (STAC-R)
See this image and copyright information in PMC

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