Anemia and Mild Cognitive Impairment in the German General Population

Article type: Research Article

Authors: Dlugaj, Martha^{a; *} | Winkler, Angela^a | Weimar, Christian^a | Dürig, Jan^b | Broecker-Preuss, Martina^c | Dragano, Nico^d | Moebus, Susanne^e | Jöckel, Karl-Heinz^e | Erbel, Raimund^f | Eisele, Lewin^e | on behalf of the Heinz Nixdorf Recall Study Investigative Group

Affiliations: [a] Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany | [b] Department of Hematology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany | [c] Department of Endocrinology, Division of Laboratory Research, University Hospital of Essen, University Duisburg-Essen, Essen, Germany | [d] Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany | [e] Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany | [f] Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Essen, Germany

Correspondence: [*] Correspondence to: Martha Dlugaj, PhD, University Hospital Essen, Department of Neurology, Hufelandstr. 55, 45147 Essen, Germany. Tel.: +49 201 723 2588; Fax: +49 201 723 5901; E-mail: Martha.Dlugaj@uk-essen.de

Abstract: There is increasing evidence that anemia is associated with cognitive impairment. Therefore, the aim of the study was to examine the cross-sectional association of anemia as well as the persistence of anemia over the last five years with mild cognitive impairment (MCI) and MCI subtypes (amnestic/non-amnestic MCI (aMCI/naMCI)). Out of 4,157 participants (50% men, 50–80 years) of the second examination (t1) of a cohort study (baseline (t0) 2000–2003), we included 4,033 participants with available hemoglobin information and complete cognitive assessment. Anemia was defined as hemoglobin <13 g/dl in men (n = 84) and <12 g/dl in women (n = 79). Group comparisons were used to compare the cognitive subtests. To determine the association of MCI with anemia at t1, with anemia five years prior to the cognitive assessment (t0) and anemia at both time points, we used logistic regression models and included 579 participants with MCI and 1,438 cognitively normal participants out of the total cohort. Anemic participants showed lower performances in verbal memory and executive functions. The fully adjusted odds ratios (OR) for MCI, aMCI, and naMCI in anemic versus non-anemic participants were 1.92 (95% -CI, 1.09–3.39), 1.96 (1.00–3.87), and 1.88 (0.91–3.87). Anemia at both times points showed a non-significant association with naMCI (OR 3.74, 0.94–14.81, fully adjusted). Our results suggest that anemia is associated with an increased risk of MCI independent of traditional cardiovascular risk factors. The association of anemia and MCI has important clinical relevance, because many causes of anemia can be treated effectively.

Keywords: Aging, anemia, epidemiology, MCI, mild cognitive impairment

DOI: 10.3233/JAD-150434

Journal: Journal of Alzheimer's Disease, vol. 49, no. 4, pp. 1031-1042, 2016