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Hemoglobin and anemia in relation to dementia risk and accompanying changes on brain MRI.
Wolters, Frank J; Zonneveld, Hazel I; Licher, Silvan; Cremers, Lotte G M; Ikram, M Kamran; Koudstaal, Peter J; Vernooij, Meike W; Ikram, M Arfan.
Afiliación
  • Wolters FJ; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands.
  • Zonneveld HI; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands.
  • Licher S; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands.
  • Cremers LGM; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands.
  • Ikram MK; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands.
  • Koudstaal PJ; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands.
  • Vernooij MW; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands.
  • Ikram MA; From the Departments of Epidemiology (F.J.W., H.I.Z., S.L., L.G.M.C., M.K.I., M.W.V., M.A.I.), Neurology (F.J.W., M.K.I., P.J.K.), and Radiology (H.I.Z., L.G.M.C., M.W.V.), Erasmus Medical Center, Rotterdam, the Netherlands. m.a.ikram@erasmusmc.nl.
Neurology ; 93(9): e917-e926, 2019 08 27.
Article en En | MEDLINE | ID: mdl-31366722
OBJECTIVE: To determine the long-term association of hemoglobin levels and anemia with risk of dementia, and explore underlying substrates on brain MRI in the general population. METHODS: Serum hemoglobin was measured in 12,305 participants without dementia of the population-based Rotterdam Study (mean age 64.6 years, 57.7% women). We determined risk of dementia and Alzheimer disease (AD) (until 2016) in relation to hemoglobin and anemia. Among 5,267 participants without dementia with brain MRI, we assessed hemoglobin in relation to vascular brain disease, structural connectivity, and global cerebral perfusion. RESULTS: During a mean follow-up of 12.1 years, 1,520 individuals developed dementia, 1,194 of whom had AD. We observed a U-shaped association between hemoglobin levels and dementia (p = 0.005), such that both low and high hemoglobin levels were associated with increased dementia risk (hazard ratio [95% confidence interval (CI)], lowest vs middle quintile 1.29 [1.09-1.52]; highest vs middle quintile 1.20 [1.00-1.44]). Overall prevalence of anemia was 6.1%, and anemia was associated with a 34% increased risk of dementia (95% CI 11%-62%) and 41% (15%-74%) for AD. Among individuals without dementia with brain MRI, similar U-shaped associations were seen of hemoglobin with white matter hyperintensity volume (p = 0.03), and structural connectivity (for mean diffusivity, p < 0.0001), but not with presence of cortical and lacunar infarcts. Cerebral microbleeds were more common with anemia. Hemoglobin levels inversely correlated to cerebral perfusion (p < 0.0001). CONCLUSION: Low and high levels of hemoglobin are associated with an increased risk of dementia, including AD, which may relate to differences in white matter integrity and cerebral perfusion.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Encéfalo / Hemoglobinas / Infarto Encefálico / Demencia / Enfermedad de Alzheimer / Anemia Tipo de estudio: Etiology_studies / Prevalence_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Neurology Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Encéfalo / Hemoglobinas / Infarto Encefálico / Demencia / Enfermedad de Alzheimer / Anemia Tipo de estudio: Etiology_studies / Prevalence_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Neurology Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos