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Haemoglobin, anaemia, dementia and cognitive decline in the elderly, a systematic review.

Abstract

BACKGROUND

Anaemia may increase risk of dementia or cognitive decline. There is also evidence that high haemoglobin levels increase risk of stroke, and consequently possible cognitive impairment. The elderly are more at risk of developing dementia and are also more likely to suffer from anaemia, although there is relatively little longitudinal literature addressing this association.

METHODS

To evaluate the evidence for any relationship between incident cognitive decline or dementia in the elderly and anaemia or haemoglobin level, we conducted a systematic review and meta-analyses of peer reviewed publications. Medline, Embase and PsychInfo were searched for English language publications between 1996 and 2006. Criteria for inclusion were longitudinal studies of subjects aged > or =65, with primary outcomes of incident dementia or cognitive decline. Other designs were excluded.

RESULTS

Three papers were identified and only two were able to be combined into a meta-analysis. The pooled hazard ratio for these two studies was 1.94 (95 percent confidence intervals of 1.32-2.87) showing a significantly increased risk of incident dementia with anaemia. It was not possible to investigate the effect of higher levels of haemoglobin.

CONCLUSION

Anaemia is one factor to bear in mind when evaluating risk of incident dementia. However, there are few data available and the studies were methodologically varied so a cautionary note needs to be sounded and our primary recommendation is that further robust research be carried out.

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  • Authors+Show Affiliations

    ,

    Experimental Medicine and Toxicology, Imperial College Faculty of Medicine, Hammersmith campus, Du Cane Road, London, W12 0NN, UK. r.peters@imperial.ac.uk

    , , , ,

    Source

    BMC geriatrics 8: 2008 Aug 08 pg 18

    MeSH

    Age Distribution
    Aged
    Aged, 80 and over
    Anemia
    Cognition Disorders
    Confidence Intervals
    Dementia
    Female
    Geriatric Assessment
    Hemoglobins
    Humans
    Incidence
    Longitudinal Studies
    Male
    Probability
    Prognosis
    Risk Assessment
    Sensitivity and Specificity
    Severity of Illness Index
    Sex Distribution

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    18691409

    Citation

    Peters, Ruth, et al. "Haemoglobin, Anaemia, Dementia and Cognitive Decline in the Elderly, a Systematic Review." BMC Geriatrics, vol. 8, 2008, p. 18.
    Peters R, Burch L, Warner J, et al. Haemoglobin, anaemia, dementia and cognitive decline in the elderly, a systematic review. BMC Geriatr. 2008;8:18.
    Peters, R., Burch, L., Warner, J., Beckett, N., Poulter, R., & Bulpitt, C. (2008). Haemoglobin, anaemia, dementia and cognitive decline in the elderly, a systematic review. BMC Geriatrics, 8, p. 18. doi:10.1186/1471-2318-8-18.
    Peters R, et al. Haemoglobin, Anaemia, Dementia and Cognitive Decline in the Elderly, a Systematic Review. BMC Geriatr. 2008 Aug 8;8:18. PubMed PMID: 18691409.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Haemoglobin, anaemia, dementia and cognitive decline in the elderly, a systematic review. AU - Peters,Ruth, AU - Burch,Lisa, AU - Warner,James, AU - Beckett,Nigel, AU - Poulter,Ruth, AU - Bulpitt,Christopher, Y1 - 2008/08/08/ PY - 2008/01/25/received PY - 2008/08/08/accepted PY - 2008/8/12/pubmed PY - 2008/12/17/medline PY - 2008/8/12/entrez SP - 18 EP - 18 JF - BMC geriatrics JO - BMC Geriatr VL - 8 N2 - BACKGROUND: Anaemia may increase risk of dementia or cognitive decline. There is also evidence that high haemoglobin levels increase risk of stroke, and consequently possible cognitive impairment. The elderly are more at risk of developing dementia and are also more likely to suffer from anaemia, although there is relatively little longitudinal literature addressing this association. METHODS: To evaluate the evidence for any relationship between incident cognitive decline or dementia in the elderly and anaemia or haemoglobin level, we conducted a systematic review and meta-analyses of peer reviewed publications. Medline, Embase and PsychInfo were searched for English language publications between 1996 and 2006. Criteria for inclusion were longitudinal studies of subjects aged > or =65, with primary outcomes of incident dementia or cognitive decline. Other designs were excluded. RESULTS: Three papers were identified and only two were able to be combined into a meta-analysis. The pooled hazard ratio for these two studies was 1.94 (95 percent confidence intervals of 1.32-2.87) showing a significantly increased risk of incident dementia with anaemia. It was not possible to investigate the effect of higher levels of haemoglobin. CONCLUSION: Anaemia is one factor to bear in mind when evaluating risk of incident dementia. However, there are few data available and the studies were methodologically varied so a cautionary note needs to be sounded and our primary recommendation is that further robust research be carried out. SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/18691409/Haemoglobin_anaemia_dementia_and_cognitive_decline_in_the_elderly_a_systematic_review_ L2 - https://bmcgeriatr.biomedcentral.com/articles/10.1186/1471-2318-8-18 DB - PRIME DP - Unbound Medicine ER -