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Review
. 2019 Dec:132:104580.
doi: 10.1016/j.nbd.2019.104580. Epub 2019 Aug 24.

Obesity-related cognitive impairment: The role of endothelial dysfunction

Joy Jones Buie  1 , Luke S Watson  2 , Crystal J Smith  3 , Catrina Sims-Robinson  4
Affiliations
Review

Obesity-related cognitive impairment: The role of endothelial dysfunction

Joy Jones Buie et al. Neurobiol Dis. 2019 Dec.

Abstract

Obesity is a global pandemic associated with macro- and microvascular endothelial dysfunction. Microvascular endothelial dysfunction has recently emerged as a significant risk factor for the development of cognitive impairment. In this review, we present evidence from clinical and preclinical studies supporting a role for obesity in cognitive impairment. Next, we discuss how obesity-related hyperinsulinemia/insulin resistance, systemic inflammation, and gut dysbiosis lead to cognitive impairment through induction of endothelial dysfunction and disruption of the blood brain barrier. Finally, we outline the potential clinical utility of dietary interventions, exercise, and bariatric surgery in circumventing the impacts of obesity on cognitive function.

Keywords: diet; gut dysbiosis; hyperinsulinemia; inflammation; insulin resistance; memory.

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Conflict of interest statement

Competing interests

The authors declare no competing interests.

Figures

Figure 1.
Figure 1.. Obesity induces cognitive decline.
Schematic illustrating how the consequences of obesity (hyperinsulinemia, adiposity, and gut dysbiosis) results in the production of tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6). This culminates into endothelial dysfunction, which leads to increased cytokine influx, increased blood brain barrier (BBB) permeability, and reduced insulin transport in the brain. This feed forward cycle of insults ultimately contribute to cognitive impairment.
See this image and copyright information in PMC

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