• Olga Ribeiro, Isabel Carmo, Teresa Paiva, and Maria Luísa Figueira.
• Unidade de Neuropsicologia. Hospital de Egas Moniz. Lisboa. ISAMB - Instituto de Saúde Ambiental. Lisboa. Portugal.
• Acta Medica Port. 2020 Jan 3; 33 (1): 38-48.

IntroductionObesity is a significant risk factor for multiple comorbidities, and its relation to neurocognitive disfunction is particularly important in cognitive decline, especially in middle age. Due to their impact on neurodegeneration, we sought to explore neuropsychological profile, cognitive reserve and emotional distress in patients with severe obesity.Material And MethodsWe used a sociodemographic and clinical questionnaire, neuropsychological tests and a symptom self-reported scale of emotional distress. We evaluated the cognitive performance of 120 patients, aged between 18 and 65 years, in treatment for their severe obesity in Portugal, between May 2012 and December 2015.ResultsCognitive performance was below the mean for the Portuguese population, for immediate recall, visuoperception, resistance to interference and cognitive flexibility. Cognitive reserve was mostly low, especially in the older groups and groups with low professional status and increased associated with better cognitive outcomes. Emotional distress was shown to be higher in our sample compared with a normative sample. The risk factors evaluated were important in the worsening of cognitive functions. Cognitive performance decreased with age.DiscussionSevere obesity was associated with a poorer cognitive performance of the sample. The cognitive reserve was greater in the younger groups. There was a significant presence of emotional distress, especially among women.ConclusionSevere obesity is associated with an impairment in cognitive and emotional performance, aggravated by aging, cognitive reserve, and comorbidity. This study emphasizes the need for preventive actions, such as neuropsychological screening, in the detection of changes and the design of better interventions.

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