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Qiang YX, Deng YT, Zhang YR, Wang HF, Zhang W, Dong Q, Feng JF, Cheng W, Yu JT. Associations of blood cell indices and anemia with risk of incident dementia: A prospective cohort study of 313,448 participants. Alzheimers Dement 2023; 19:3965-3976. [PMID: 37102212 DOI: 10.1002/alz.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Low hemoglobin and anemia are associated with cognitive impairment and Alzheimer's disease (AD). However, the associations of other blood cell indices with incident dementia risk and the underlined mechanisms are unknown. METHODS Three hundred thirteen thousand four hundred forty-eight participants from the UK Biobank were included. Cox and restricted cubic spline models were used to investigate linear and non-linear longitudinal associations. Mendelian randomization analysis was used to identify causal associations. Linear regression models were used to explore potential mechanisms driven by brain structures. RESULTS During a mean follow-up of 9.03 years, 6833 participants developed dementia. Eighteen indices were associated with dementia risk regarding erythrocytes, immature erythrocytes, and leukocytes. Anemia was associated with a 56% higher risk of developing dementia. Hemoglobin and red blood cell distribution width were causally associated with AD. Extensive associations exist between most blood cell indices and brain structures. DISCUSSION These findings consolidated associations between blood cells and dementia. HIGHLIGHT Anemia was associated with 56% higher risk for all-cause dementia. Hematocrit percentage, mean corpuscular volume, platelet crit, and mean platelet volume had U-shaped associations with incident dementia risk. Hemoglobin (HGB) and red blood cell distribution width had causal effects on Alzheimer's risk. HGB and anemia were associated with brain structure alterations.
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Affiliation(s)
- Yi-Xuan Qiang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yue-Ting Deng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ya-Ru Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hui-Fu Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Qiang Dong
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Wei Cheng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China
- Shanghai Medical College and Zhongshan Hospital Immunotherapy Technology Transfer Center, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
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Kung WM, Yuan SP, Lin MS, Wu CC, Islam MM, Atique S, Touray M, Huang CY, Wang YC. Anemia and the Risk of Cognitive Impairment: An Updated Systematic Review and Meta-Analysis. Brain Sci 2021; 11:brainsci11060777. [PMID: 34208355 PMCID: PMC8231247 DOI: 10.3390/brainsci11060777] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cognitive impairment is one of the most common, burdensome, and costly disorders in the elderly worldwide. The magnitude of the association between anemia and overall cognitive impairment (OCI) has not been established. OBJECTIVE We aimed to update and expand previous evidence of the association between anemia and the risk of OCI. METHODS We conducted an updated systematic review and meta-analysis. We searched electronic databases, including EMBASE, PubMed, and Web of Science for published observational studies and clinical trials between 1 January 1990 and 1 June 2020. We excluded articles that were in the form of a review, letter to editors, short reports, and studies with less than 50 participants. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We estimated summary risk ratios (RRs) with random effects. RESULTS A total of 20 studies, involving 6558 OCI patients were included. Anemia was significantly associated with an increased risk of OCI (adjusted RR (aRR) 1.39 (95% CI, 1.25-1.55; p < 0.001)). In subgroup analysis, anemia was also associated with an increased risk of all-cause dementia (adjusted RR (aRR), 1.39 (95% CI, 1.23-1.56; p < 0.001)), Alzheimer's disease [aRR, 1.59 (95% CI, 1.18-2.13; p = 0.002)], and mild cognitive impairment (aRR, 1.36 (95% CI, 1.04-1.78; p = 0.02)). CONCLUSION This updated meta-analysis shows that patients with anemia appear to have a nearly 1.39-fold risk of developing OCI than those without anemia. The magnitude of this risk underscores the importance of improving anemia patients' health outcomes, particularly in elderly patients.
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Affiliation(s)
- Woon-Man Kung
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei 11114, Taiwan; (W.-M.K.); (C.-C.W.)
| | - Sheng-Po Yuan
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan; (S.-P.Y.); (M.M.I.)
- Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 11600, Taiwan
- Department of Otorhinolaryngology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Muh-Shi Lin
- Department of Biotechnology and Animal Science, College of Bioresources, National Ilan University, Yilan 26047, Taiwan;
- Division of Neurosurgery, Department of Surgery, Kuang Tien General Hospital, Taichung 43303, Taiwan
- Department of Biotechnology, College of Medical and Health Care, Hung Kuang University, Taichung 43302, Taiwan
- Department of Health Business Administration, College of Medical and Health Care, Hung Kuang University, Taichung 43302, Taiwan
| | - Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei 11114, Taiwan; (W.-M.K.); (C.-C.W.)
| | - Md. Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan; (S.-P.Y.); (M.M.I.)
| | - Suleman Atique
- Department of Health Informatics, College of Public Health and Health Informatics, University of Ha’il, Ha’il 55211, Saudi Arabia;
| | - Musa Touray
- Department of Public Health, University of The Gambia, Serrekunda 3530, The Gambia;
| | - Chu-Ya Huang
- Taiwan College of Healthcare Executives, Taipei 106607, Taiwan;
| | - Yao-Chin Wang
- Department of Emergency, Min-Sheng General Hospital, Taoyuan 33044, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-3-317-9599 (ext. 8134)
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