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Canadian Journal of Cardiology

Obese but Fit: The Benefits of Fitness on Cognition in Obese Older Adults

  • Maxime Boidin
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Nicolas Handfield
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Paula A.B. Ribeiro
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada

    Postgraduate Program in Health Science Cardiology and Cardiovascular Sciences, Porto Alegre, Rio Grande do Sul, Brazil
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  • Laurence Desjardins-Crépeau
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Christine Gagnon
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Gabriel Lapierre
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Vincent Gremeaux
    Affiliations
    Swiss Olympic Medical Center of the Lausanne University Hospital, Institut des Sciences du Sports de l'Université de Lausanne, Lausanne, Switzerland
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  • Julie Lalongé
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Anil Nigam
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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  • Martin Juneau
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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  • Mathieu Gayda
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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  • Louis Bherer
    Correspondence
    Corresponding author: Dr Louis Bherer, Research Center, Montreal Heart Institute, Université de Montréal, 5000 Bélanger, Montréal, Québec H1T 1C8, Canada. Tel.: +1-514-376-3330 ext 2059.
    Affiliations
    Centre de médecine préventive et d’activité physique (Centre ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Research Center, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada

    Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
    Search for articles by this author
Published:January 16, 2020DOI:https://doi.org/10.1016/j.cjca.2020.01.005

      Abstract

      Background

      Obesity is associated with an accelerated cognitive decline. Aerobic fitness has a protective effect on cognition in older adults, but no study has investigated this effect in obese individuals. The present study aimed to 1) compare cognitive function in lower-fit (LoFit) and higher-fit (HiFit) obese individuals compared with nonobese individuals, and 2) examine the association between exercise variables (including hemodynamic variables) and cognitive function in obese individuals.

      Methods

      Fifty-four obese and 16 nonobese individuals performed a maximal cardiopulmonary exercise test (with gas exchange analysis and noninvasive hemodynamic measurement) and cognitive tests assessing short-term and working memory, processing speed, executive function, and long-term verbal memory. Obese individuals were divided into 2 groups according to their median aerobic fitness divided by lean body mass to form a group of LoFit obese (n = 27) and a group of HiFit obese (n = 27) individuals.

      Results

      A total of 14 nonobese individuals and 49 obese individuals were included in the final analysis (HiFit: n = 26, LoFit: n = 23). Compared with LoFit obese, HiFit obese participants had greater performances in executive function (P = 0.002) and short-term memory (P = 0.02). Nonobese and HiFit obese participants showed equivalent performances in all domains of cognition. In obese individuals, aerobic fitness was the only independent predictor for short-term memory (R2 = 0.24; P < 0.001), working memory (R2 = 0.16; P = 0.02), processing speed (R2 = 0.22; P = 0.01), and executive function (R2 = 0.49; P = 0.003), but not for long-term verbal memory (R2 = 0.15; P = 0.26).

      Conclusions

      HiFit obese individuals showed greater short-term memory and executive function performances compared with LoFit obese individuals, suggesting that aerobic fitness could help preserve cognitive function despite the presence of obesity.

      Résumé

      Introduction

      L’obésité est associée à un déclin cognitif accéléré. L’aptitude aérobie a un effet protecteur sur la cognition des personnes âgées, mais aucune étude n’a montré cet effet chez les individus obèses. La présente étude avait pour but de : 1) comparer les performances cognitives des individus obèses en moins bonne forme physique (LoFit, de l’anglais lower-fit) et en meilleure forme physique (HiFit, de l’anglais higher-fit) aux individus non obèses; 2) d’examiner l’association entre les variables physiques (y compris les variables hémodynamiques) et les performances cognitives chez les individus obèses.

      Méthodes

      Cinquante-quatre individus obèses et 16 individus non obèses ont effectué une épreuve d’effort cardiopulmonaire maximal (avec analyse des échanges gazeux et mesures hémodynamiques non invasives) et des épreuves cognitives évaluant la mémoire à court terme et de travail, la vitesse de traitement, la fonction exécutive et la mémoire verbale à long terme. Nous avons réparti les individus obèses en 2 groupes selon la médiane de l'aptitude aérobie divisée par la masse corporelle maigre pour former un groupe d’individus obèses en moins bonne forme physique (LoFit, n = 27) et un groupe d’individus obèses en meilleure forme physique (HiFit, n = 27).

      Résultats

      Nous avons inclus un total de 14 individus non obèses et 49 individus obèses dans l’analyse finale (HiFit : n = 26, LoFit : n = 23). Comparativement aux participants obèses en moins bonne forme physique, les participants obèses en meilleure forme physique avaient de meilleures performances dans la fonction exécutive (P = 0,002) et dans la mémoire à court terme (P = 0,02). Les participants non obèses et les participants obèses en meilleure forme physique montraient des performances équivalentes dans toutes les sphères de la cognition. Chez les individus obèses, l’aptitude aérobie était le seul prédicteur indépendant de la mémoire à court terme (R2 = 0,24; P < 0,001), de la mémoire de travail (R2 = 0,16; P = 0,02), de la vitesse de traitement (R2 = 0,22; P = 0,01) et de la fonction exécutive (R2 = 0,49; P = 0,003), mais non de la mémoire verbale à long terme (R2 = 0,15; P = 0,26).

      Conclusions

      Les individus obèses en meilleure forme physique montraient de meilleures performances dans la mémoire à court terme et dans la fonction exécutive que les individus obèses en moins bonne forme physique. Ces constatations montrent que l’aptitude aérobie pourrait contribuer à préserver les performances cognitives en dépit de la présence de l’obésité.
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