07:59pm Friday 15 December 2017

Link Between Anemia and Mild Cognitive Impairment

In a large population-based study of randomly selected participants in Germany, researchers found that participants with anemia, defined as haemoglobin

Because dementia is the end stage of many years of accumulation of pathological changes in the brain, researchers focus on early stages of cognitive impairment. MCI represents an intermediate and possibly modifiable stage between normal cognitive aging and dementia. Although persons with MCI have an increased risk of developing dementia or Alzheimer’s disease (AD), they can also remain stable for many years or even revert to a cognitively normal state over time. This modifiable characteristic makes the concept of MCI a promising target in the prevention of dementia.

What criteria determine MCI? The following four criteria were used to diagnose MCI: First, participants have to report a decline in cognitive performance over the past two years. Second, the participants have to show a cognitive impairment in objective cognitive tasks that is greater than one would expect taking their age and education into consideration. Third, this impairment is not as pronounced as in demented individuals since persons with MCI can perform normal daily living activities or are only slightly impaired in carrying out complex instrumental functions. Fourth, the cognitive impairment is insufficient to fulfil criteria for dementia.

The concept of MCI distinguishes between amnestic MCI (aMCI) and non-amnestic MCI (naMCI). In the former, impairment in the memory domain is evident, most likely reflecting AD pathology. In the latter, impairment in non-memory domains is present, mainly reflecting vascular pathology but also frontotemporal dementia or dementia with Lewy bodies.

The Heinz Nixdorf Recall (Risk Factors, Evaluation of Coronary Calcium and Lifestyle) study is an observational, population-based, prospective study that examined 4,814 participants (50% men) between 2000 and 2003 in the metropolitan Ruhr Area. After five years, a second examination was conducted with 92% of the participants taking part. The publication reports cross-sectional results of the second examination.

First, 163 participants with anemia and 3,870 participants without anemia were included to compare the performance in all cognitive subtests. Interestingly, anemic participants showed more pronounced cardiovascular risk profiles and lower cognitive performance in all administered cognitive subtests. After adjusting for age, anemic participants showed a significantly lower performance specifically in the immediate recall task and the verbal fluency task.

Second, 579 participants diagnosed with MCI (299 participants with aMCI and 280 with naMCI) and 1,438 cognitively normal participants were included to compare the frequency of MCI and MCI subtype diagnosis in anemic and non-anemic participants. MCI occurred almost twice more often in anemic than in non-anemic participants. Similar results were found for MCI subtypes, indicating that low hemoglobin level may contribute to cognitive impairment via different pathways.

These 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 -depending on etiology- anemia can be treated effectively. This might provide means to prevent or delay cognitive decline.

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NOTES FOR EDITORS

Anemia and Mild Cognitive Impairment in the German General Population.
Martha Dlugaj, Angela Winkler, Christian Weimar, Jan Dürig, Martina Broecker-Preuss, Nico Dragano, Susanne Moebus, Karl-Heinz Jöckel, Raimund Erbel, Lewin Eisele on behalf the Heinz Nixdorf Recall Study Investigative Group.Journal of Alzheimer’s Disease, Volume 49/4 (December 2015): DOI: 10.3233/JAD-150434

Reporters who wish to speak to the authors should contact martha.dlugaj@uk-essen.de

ABOUT THE JOURNAL OF ALZHEIMER’S DISEASE (JAD)

The  Journal of Alzheimer’s Disease is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer’s disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Groundbreaking research that has appeared in the journal includes novel therapeutic targets, mechanisms of disease and clinical trial outcomes. The Journal of Alzheimer’s Disease has an Impact Factor of 4.151 according to Thomson Reuters’ 2014 Journal Citation Reports. The Journal is published by IOS Press.

ABOUT IOS PRESS

Commencing its publishing activities in 1987, IOS Press serves the information needs of scientific and medical communities worldwide. IOS Press now (co-)publishes over 100 international journals and about 75 book titles each year on subjects ranging from computer sciences and mathematics to medicine and the natural sciences.

IOS Press continues its rapid growth, embracing new technologies for the timely dissemination of information. All journals are available electronically and an e-book platform was launched in 2005.

Headquartered in Amsterdam with satellite offices in the USA, Germany, India and China, IOS Press has established several strategic co-publishing initiatives. Notable acquisitions included Delft University Press in 2005 and Millpress Science Publishers in 2008.

Contacts:

George Perry, PhD
Editor-in-Chief, Journal of Alzheimer’s Disease
Dean and Professor of Biology, The University of Texas at San Antonio
Tel: +1 210 458 4450
Fax:+1 210 458 4445
Email: george.perry@utsa.edu

Daphne Watrin
IOS Press
Tel: +31 20 688 3355
Fax: +31 20 687 0019
Email: d.watrin@iospress.nl


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