title: Low Hemoglobin Levels and the Onset of Cognitive Impairment in Older People: The PRO.V.A. Study.
abstract: Low hemoglobin (Hb) levels are attracting interest as a risk factor for cognitive impairment, but with contrasting evidence emerging from the current literature. The aim of our work was to investigate the relationship between baseline serum Hb levels and the incidence of cognitive impairment in older people over a follow-up of 4.4 years. Our study considered a sample of 1227 elderly subjects cognitively intact at baseline, enrolled under the Progetto Veneto Anziani (Pro.V.A.) among 3099 screened subjects. For all participants, we measured serum Hb levels on blood samples; incident cognitive impairment was defined as a Mini Mental State Examination (MMSE) score <24 and confirmed by geriatricians skilled in psychogeriatric medicine. No differences in baseline MMSE scores across Hb tertiles emerged in either gender. After the 4.4 years of follow-up, we identified 403 new cases of cognitive impairment (147 men and 256 women). Cox's regression analysis showed that participants with the lowest baseline Hb concentrations carried a significant 37% higher risk (95% confidence interval [CI]: 1.08-1.75; p = 0.01) of being diagnosed with cognitive impairment during the follow-up. Considering the gender separately, the risk of cognitive impairment only increased significantly, by 60%, for men in the lowest Hb tertile (95% CI: 1.06-2.41; p = 0.02), but not for women (hazard ratio = 1.32; 95% CI: 0.97-1.79; p = 0.08). In conclusion, low Hb concentrations may predict the onset of cognitive impairment in the elderly, apparently with a stronger association in men than in women.
authors.affiliation: 1 Geriatrics Division, Department of Medicine-DIMED, University of Padova , Padova, Italy .
authors.forename: Caterina
authors.initials: C
authors.lastname: Trevisan
authors.affiliation: 1 Geriatrics Division, Department of Medicine-DIMED, University of Padova , Padova, Italy .
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: 1 Geriatrics Division, Department of Medicine-DIMED, University of Padova , Padova, Italy .
authors.forename: Francesco
authors.initials: F
authors.lastname: Bolzetta
authors.affiliation: 1 Geriatrics Division, Department of Medicine-DIMED, University of Padova , Padova, Italy .
authors.forename: Marina
authors.initials: M
authors.lastname: De Rui
authors.affiliation: 2 National Research Council, Neuroscience Institute , Padova, Italy .
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.affiliation: 2 National Research Council, Neuroscience Institute , Padova, Italy .|3 Department of Medicine-DIMED, Clinica Medica I, University of Padova , Padova, Italy .
authors.forename: Sabina
authors.initials: S
authors.lastname: Zambon
authors.affiliation: 3 Department of Medicine-DIMED, Clinica Medica I, University of Padova , Padova, Italy .
authors.forename: Estella
authors.initials: E
authors.lastname: Musacchio
authors.affiliation: 3 Department of Medicine-DIMED, Clinica Medica I, University of Padova , Padova, Italy .
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sartori
authors.affiliation: 4 Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences-Biostatistics, University of Padova , Padova, Italy .
authors.forename: Egle
authors.initials: E
authors.lastname: Perissinotto
authors.affiliation: 2 National Research Council, Neuroscience Institute , Padova, Italy .
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.affiliation: 1 Geriatrics Division, Department of Medicine-DIMED, University of Padova , Padova, Italy .|2 National Research Council, Neuroscience Institute , Padova, Italy .
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.affiliation: 1 Geriatrics Division, Department of Medicine-DIMED, University of Padova , Padova, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000097:blood* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D015994:Incidence; D008297:Male; D012727:Sex Characteristics
chemical_list: D006454:Hemoglobins
keywords: anemia; cognitive impairment; dementia; elderly; hemoglobin concentration; sex differences