減重後,記憶功能可增加?


  【24drs.com】根據一篇新研究的結果,接受減重手術的肥胖者,記憶功能改善。
  
  俄亥俄州Kent州立大學的研究者John Gunstad博士表示,這篇研究有兩個重點希望大家記住。首先,這篇研究清楚顯示,肥胖引起腦部出現不良改變,但是其中有些可以藉由減重恢復。其次,如果肥胖者需要有其他促進減重的動機,這就是了。
  
  Gunstad博士表示,他們的研究動機是,從之前的臨床工作獲得「減重是否可以改善記憶與專注力」的觀念。
  
  他表示,他在羅德島的布朗大學醫學院任職時,和其他研究者探討透過行為方式或減重手術減重。注意這些病患是否在認知功能檢測中有同樣的錯誤。
  
  在這篇研究中,研究者探討了納入「Longitudinal Assessment of Bariatric Surgery」這項研究的109名減重手術病患,以及41名沒有進行任何減重手術的肥胖對照組。所有的研究對象在研究開始時與追蹤12週時完成認知功能評估。
  
  Gunstad博士表示,研究對象的平均體重是300磅(136公斤),進行減重手術者在12週時減輕約50磅(22.7公斤)。
  
  開始時,許多減重手術病患的認知檢測表現不佳,但是在12週時,他們的記憶與專注程度比對照組改善(P < .001),事實上,肥胖病患的記憶表現曾經明確衰退。
  
  Gunstad博士表示,減重手術病患許多與控制肥胖有關的檢測結果都有所改善,包括多元記憶指數以及心理運動速度檢測。此外,相較於有高血壓者,沒有高血壓的手術病患在12週時有較佳的短期延遲回憶(P = .005)。
  
  他表示,我們知道進行減重手術者會明顯減輕50磅(22.7公斤)以上,所以,研究者將追蹤這些病患達術後2年,看他們是否持續減重、密切觀察這段追蹤期間所發生的狀況。
  
  紐約大學Langone醫學中心精神科醫師Sudeepta Varma表示,這篇研究的結果令人振奮與鼓舞;知道這點有助於治療肥胖病患,或許應與一線照護醫師密切合作,並轉介這些病患進行減重手術,這類手術是可嚐試的選項,提供更多可運用的治療方式。
  
  減重也可幫助肥胖病患改善憂鬱。她指出,肥胖者的憂鬱症比率高,現在,治療肥胖也可治療憂鬱的可能性增加。這篇研究讓我們有信心地說:認知功能衰退是可以改變的。
  
  資料來源:http://www.24drs.com/professional/list/content.asp?x_idno=6502&x_classno=0&x_chkdelpoint=Y
  

Lose Weight, Gain Memory Function?

By Fran Lowry
Medscape Medical News

April 19, 2011 — Obese individuals who undergo bariatric surgery show evidence of improved memory function, according to the results of a new study.

"There are 2 take-home messages from our research," lead study author John Gunstad, PhD, from Kent State University in Ohio, told Medscape Medical News.

"The first is that this very clearly demonstrates that obesity causes adverse changes to the brain but that some of these changes might be reversible through significant weight loss. The second is if obese individuals are looking for yet another reason to motivate them to lose weight, this is it."

Dr. Gunstad said he and his colleagues got the idea to study whether weight loss improved memory and concentration from previous clinical work.

"I was working at Brown University Medical School in Rhode Island with people who were looking to lose weight through behavioral means or weight loss surgery. I kept noticing that these patients would make the same mistakes on cognitive function tests," he said.

More Benefit With Time?

In this study he and his team studied 109 bariatric surgery patients who were enrolled in the Longitudinal Assessment of Bariatric Surgery project and 41 obese control subjects who were not having weight loss surgery. All subjects completed a cognitive evaluation at baseline and at 12 weeks of follow-up.

The average weight of the patients in the study was 300 lb. Those who had bariatric surgery lost about 50 lb by week 12, Dr. Gunstad said.

At baseline, many bariatric surgery patients showed impaired performance on cognitive testing, but at 12 weeks, they had demonstrated improved memory and concentration, compared with the control subjects (P < .001). In fact, the memory performance of the obese subjects had actually declined.

"Several test results improved in the bariatric surgery patients relative to the obese controls, including multiple memory indexes and a test of psychomotor speed," Dr. Gunstad said.

In addition, surgery patients without hypertension had better short delay recall at 12 weeks than those with hypertension (P = .005).

"We know that people who go through weight loss surgery are going to lose substantially more than just 50 lb, so we are going to follow these patients for up to 2 years after their surgery as they continue to lose weight to take a closer look at what happens over the course of time," he said.

Ray of Hope

For Sudeepta Varma, MD, a psychiatrist at New York University Langone Medical Center in New York City, the results of this study are exciting and encouraging.

"It is nice to know that if I am treating an obese patient, perhaps I should work closely with the primary care doctor and we should refer this patient for bariatric surgery. Such surgery may be an option to try. It gives us more tools to work with," she told Medscape Medical News.

Losing weight may also help improve depression in obese patients, she added.

"We see a high rate of depression in obesity. Now the possibility is raised that treating the obesity might treat the underlying depression. This study gives us a little bit of hope to say that declining cognitive function does not have to be this person’s destiny, that things can be changed," she said.

This study was supported by the National Institutes of Health. Dr. Gunstad and Dr. Varma have disclosed no relevant financial relationships.

Surg Obes Relat Dis. Published online October 4, 2010.

    
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