Title:Association Between Anemia and Dementia: A Nationwide, Populationbased Cohort Study in Taiwan
Volume: 17
Issue: 2
Author(s): Chien-Tai Hong, Yi-Chen Hsieh, Hung-Yi Liu, Hung-Yi Chiou and Li-Nien Chien*
Affiliation:
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei,Taiwan
Keywords:
Dementia, anemia, population-based cohort study, competing risk analysis, subdistribution hazard ratio, apolipoprotein
E4 (ApoE4).
Abstract: Background: In addition to the traditional risk predictors, whether anemia is an early biomarker
of dementia, needs to be confirmed.
Objective: This population-based cohort study aimed to investigate the dementia risk in patients with
newly diagnosed anemia using data from the Taiwan National Health Insurance Research Database.
Methods: All newly diagnosed anemia patients (n = 26,343) with no history of stroke hospitalization,
central nervous disease other than dementia, psychiatric disorders, traumatic brain injury, major operations,
or blood loss diseases, were enrolled. A group of non-anemic controls, 1:4 matched with anemic
patients on the basis of demographics and comorbidities, was also included. A competing risk analysis
was used to evaluate the dementia risk in anemic patients compared to that of their matched controls.
Results: The adjusted subdistribution hazard ratio (SHR) of dementia risk in anemic patients was 1.14
(95% confidence interval [CI]: 1.08~1.21, p<0.001). Patients with iron supplements tended to exhibit a
lower dementia risk (adjusted SHR: 0.84; 95% CI: 0.75~0.94, p=0.002) compared to patients without
iron supplement. A subgroup analysis showed that a positive association between dementia and anemia
existed in females, those aged 70 years and older, and patients without hypertension, diabetes, or hyperlipidemia.
Conclusion: The present population-based cohort study identified that newly diagnosed anemia is a risk
factor for dementia and also that iron supplementation was able to reduce the risk of dementia in people
with iron deficiency anemia.