The relationship between obesity and cognitive health and decline

Proc Nutr Soc. 2017 Nov;76(4):443-454. doi: 10.1017/S0029665117002014. Epub 2017 Sep 11.


The relationship between obesity and cognitive impairment is important given the globally ageing population in whom cognitive decline and neurodegenerative disorders will carry grave individual, societal and financial burdens. This review examines the evidence for the link between obesity and cognitive function in terms of both the immediate effects on cognitive performance, and effects on the trajectory of cognitive ageing and likelihood of dementia. In mid-life, there is a strong association between obesity and impaired cognitive function. Anthropometric measures of obesity are also associated with reduced neural integrity (e.g. grey and white matter atrophy). Increasing age coupled with the negative metabolic consequences of obesity (e.g. type 2 diabetes mellitus) are likely to significantly contribute to cognitive decline and incidence of dementia. Stress is identified as a potential risk factor promoting abdominal obesity and contributing to impaired cognitive function. However, the potentially protective effects of obesity against cognitive decline in older age require further examination. Finally, surgical and whole diet interventions, which address obesity may improve cognitive capacity and confer some protection against later cognitive decline. In conclusion, obesity and its comorbidities are associated with impaired cognitive performance, accelerated cognitive decline and neurodegenerative pathologies such as dementia in later life. Interventions targeting mid-life obesity may prove beneficial in reducing the cognitive risks associated with obesity.

Keywords: AD Alzheimer's disease; IGT impaired glucose tolerance; MDP Mediterranean dietary pattern; T2DM type 2 diabetes mellitus; WHR waist-to-hip ratio; Cognitive decline; Cognitive performance; Dementia; Obesity.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition / physiology
  • Cognitive Aging / physiology
  • Cognitive Dysfunction / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / physiopathology
  • Obesity / psychology*
  • Risk Factors