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Anemia and Blood Biomarkers of Alzheimer Disease in Dementia Development
Martina Valletta, Davide Liborio Vetrano, Chengxuan Qiu, Marco Canevelli, Edoardo Miccoli, Sarah Wamala Andersson, Claudia Fredolini, Giuseppe Bruno et al.. JAMA Network Open, 2026-04-17
Topic: Amyloid, tau and blood-test diagnosis
A total of 3363 adults were enrolled in SNAC-K (73.3% participation rate). After excluding those with dementia or missing AD biomarkers or hemoglobin measures, 2282 dementia-free participants were included in the current study (median age, 72.2 [IQR, 60.8-81.1] years; 1406 [61.6%] female). During a mean (SD) follow-up of 9.3 (4.3) years, 362 participants (15.9%) developed dementia. Compared with individuals with a normal hemoglobin level, those with anemia had higher baseline levels of p-tau217 (β, 0.22; 95% CI, 0.15-0.30), NfL (β, 0.25; 95% CI, 0.19-0.31), and GFAP (β, 0.08; 95% CI, 0.03-0.12) and showed a higher risk of developing dementia (hazard ratio [HR], 1.66; 95% CI, 1.21-2.28) during follow-up. Participants with both anemia and high p-tau217, NfL, or GFAP had the highest hazard of dementia (eg, adjusted HR of 3.64 [95% CI, 2.39-5.56] among those with anemia and high NfL). Conclusions and Relevance: In this cohort study of dementia-free older adults, anemia was associated cross-sectionally with higher levels of AD blood biomarkers and longitudinally with increased dementia risk. The highest dementia risk occurred when low hemoglobin and elevated AD biomarkers coexisted, suggesting a potential interplay between anemia and neuropathology in dementia development.
Key findings
- A total of 3363 adults were enrolled in SNAC-K (73.3% participation rate).
- After excluding those with dementia or missing AD biomarkers or hemoglobin measures, 2282 dementia-free participants were included in the current study (median age, 72.2 [IQR, 60.8-81.1] years; 1406 [61.6%] female).
- During a mean (SD) follow-up of 9.3 (4.3) years, 362 participants (15.9%) developed dementia.
- Compared with individuals with a normal hemoglobin level, those with anemia had higher baseline levels of p-tau217 (β, 0.22; 95% CI, 0.15-0.30), NfL (β, 0.25; 95% CI, 0.19-0.31), and GFAP (β, 0.08; 95% CI, 0.03-0.12) and showed a higher risk of developing dementia (hazard ratio [HR], 1.66; 95% CI, 1.21-2.28) during follow-up.
- Participants with both anemia and high p-tau217, NfL, or GFAP had the highest hazard of dementia (eg, adjusted HR of 3.64 [95% CI, 2.39-5.56] among those with anemia and high NfL).
Why it matters
In 2282 dementia-free older adults followed for about 9 years, anemia was linked to higher levels of Alzheimer's blood biomarkers and a higher risk of developing dementia. The highest dementia risk was seen in people who had both anemia and elevated Alzheimer's biomarkers.
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Study details
- Study designcohort study
- Participants3,363
- Effect size73.3%; 61.6%; 15.9%
- Evidence strengthModerate
How this study scored 64/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Network Open) |
| Journal's citation record | 2 / 4 | JAMA Network Open: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,363 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 5 / 6 | Cited 28.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Giulia Grande: h-index 38 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41996117) |
| Free to read | 2 / 2 | Free to read |
| Total | 64 / 100 | — |
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Read the original
- DOI: 10.1001/jamanetworkopen.2026.4029
- PubMed: 41996117
- Original source →
- Free full text: JAMA Network Open →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Valletta, M., Vetrano, D. L., Qiu, C., Canevelli, M., Miccoli, E., Andersson, S. W., et al. (2026). Anemia and Blood Biomarkers of Alzheimer Disease in Dementia Development. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2026.4029
Vancouver
Valletta M, Vetrano DL, Qiu C, Canevelli M, Miccoli E, Andersson SW, et al. Anemia and Blood Biomarkers of Alzheimer Disease in Dementia Development. JAMA Network Open. 2026. doi:10.1001/jamanetworkopen.2026.4029. PMID: 41996117.
BibTeX
@article{valletta2026-41996117,
author = {Valletta, Martina and Vetrano, Davide Liborio and Qiu, Chengxuan and Canevelli, Marco and Miccoli, Edoardo and Andersson, Sarah Wamala and Fredolini, Claudia and Bruno, Giuseppe and others},
title = {{Anemia and Blood Biomarkers of Alzheimer Disease in Dementia Development}},
journal = {JAMA Network Open},
year = {2026},
doi = {10.1001/jamanetworkopen.2026.4029},
pmid = {41996117},
url = {https://doi.org/10.1001/jamanetworkopen.2026.4029}
}
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