Abnormal hemoglobin levels tied to dementia risk in elders

  • Neurology

  • International Clinical Digest
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Takeaway

  • Older adults with levels of hemoglobin outside the reference range, either low or high, had elevated dementia risk.

Why this matters

  • Increasing prevalence of dementia, coupled with lack of interventions to prevent and treat it.

Key results

  • During mean 12.1-year follow-up:
    • 12.4% of cohort developed dementia of any type.
    • 9.7% specifically developed Alzheimer’s disease.
  • Hemoglobin levels showed U-shaped association with dementia risk (P=.005).
  • When middle quintile of levels was comparator, risk was similarly elevated for:
    • Lowest quintile (HR, 1.29; 95% CI, 1.09-1.52).
    • Highest quintile (HR, 1.20; 95% CI, 1.00-1.44).
  • Anemia, present in 6.1% of cohort, conferred elevated risks for:
    • Dementia of any type (HR, 1.34; 95% CI, 1.11-1.62).
    • Alzheimer’s disease (HR, 1.41; 95% CI, 1.15-1.74).
    • Cerebral microbleeds (HR, 1.45; 95% CI, 1.09-1.93).
  • Higher hemoglobin levels correlated with lower cerebral perfusion (P<.0001>

Study design

  • Population-based cohort study of 12,305 middle-aged and older adults (mean age, 64.6 years) without dementia (Rotterdam Study).
  • Main outcomes: dementia, Alzheimer’s disease, measures on brain MRI.
  • Funding: Netherlands Cardiovascular Research Initiative; Erasmus Medical Centre; Erasmus University Rotterdam; others.

Limitations

  • Residual and unmeasured confounding.
  • MRI performed in only a subset.
  • Unknown generalizability.

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