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Anemia and the risk of dementia in the oldest‐old: The Monzino 80‐plus population‐based study
Author(s) -
Lucca Ugo,
Tettamanti Mauro,
Riva Emma,
Mandelli Sara,
Forloni Gianluigi,
Galbussera Alessia A.
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.044445
Subject(s) - medicine , anemia , dementia , stroke (engine) , population , diabetes mellitus , prospective cohort study , incidence (geometry) , pediatrics , confounding , risk factor , disease , mechanical engineering , physics , environmental health , optics , engineering , endocrinology
Background Hemoglobin concentration tends to decline and prevalence of anemia to increase with age. In recent years anemia has been repeatedly linked to a number of adverse outcomes. Anemia has also been proposed as a potential risk factor for cognitive impairment and dementia. Chronic reduction of oxygen supply to the brain could account for this association. However, evidence from prospective population‐based cohorts is very limited. Aim of the present study was to investigate the association of anemia with prevalent and incident dementia among the oldest‐old participants in the Monzino 80‐plus study. Method Consent to blood sampling was obtained in 1,115 participants in a door‐to‐door, prospective population‐based study on the prevalence and incidence of dementia among 80‐years and older residents in the province of Varese, Italy. Anemia was defined according to WHO criteria as a hemoglobin concentration <120 g/L in women and <130 g/L in men. Diagnosis of dementia fulfilled DSM‐IV criteria. Potential confounders included in "fully”‐adjusted models: age, sex, education, smoking history, alcohol consumption, hospital admission during the previous year, history of diabetes, hypertension, myocardial infarction, heart failure, respiratory failure, renal failure, stroke, TIA, parkinsonism, cancer. Result Participants were 90.3 (5.6) years old on average, 74.5% women, and had a mean (SD) 5.1 (2.5) years of education. 374 subjects (33.5%) were anemic. Mean hemoglobin concentration decreased and prevalence of anemia increased with age (both p<0.0001). Anemic oldest‐old had a lower mean MMSE score (18.3 ± 9.1) than non anemic (20.8 ± 8.0; fully‐adjusted p=0.0130). In univariate analysis, anemia status was significantly associated with increased odds of having dementia (OR: 1.62; 95%CI: 1.26‐2.08; p=0.0002). When adjusted for confounders, this cross‐sectional association was marginally non significant (fully‐adjusted OR: 1.339; 95%CI: 0.999‐1.794; p=0.0508). Over a 15‐year follow‐up period 318 subjects were diagnosed with dementia out of 614 participants without at baseline. Oldest‐old with anemia did not have a significantly increased risk of incident dementia with respect to those without (univariate analysis, HR: 1.12; 95%CI: 0.85‐1.46; p=0.4306). Conclusion In the present prospective population‐based study in the oldest‐old, anemia was not significantly associated with an increased risk of developing dementia.