Performance on the Montreal Cognitive Assessment (MoCA) in Older Adults Presenting for Bariatric Surgery

Abstract

Background: Bariatric surgery candidates exhibit cognitive impairment on neuropsychological testing and these deficits are associated with reduced post-operative weight loss. However, less is known about the prevalence of cognitive function in older adults that pursue surgery, despite being at higher risk for cognitive dysfunction.

Objective: To examine the prevalence and profile of cognitive impairment using the Montreal Cognitive Assessment (MoCA) in elderly bariatric patients. We hypothesized that increased body mass index (BMI) and higher number of medications would be linked to lower MoCA score, and that men would evidence poorer MoCA scores than women given past work showing that men presenting for bariatric surgery have more medical comorbidities.

Methods: Data was retrospectively extracted from electronic medical records. Patients 65 and older who completed pre-surgical MoCA assessment and bariatric surgery were included in the study (n = 55).

Results: Twenty-two percent of patients scored below cutoff for impairment on the MoCA. MoCA total score was negatively correlated with BMI and number of medications pre-surgery. There was a significant effect for gender, with men outperforming women.

Conclusions: The current findings suggest that cognitive impairment is common in older adults presenting for bariatric surgery. Future studies are needed to determine the most appropriate methods for detecting cognitive dysfunction in this high-risk population.

Keywords: Adherence; Bariatric surgery; Cognition; Elderly; MoCA.