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Anemia and risk of dementia in older adults: findings from the Health ABC study
Hong CH, Falvey C, Harris TB, Simonsick EM, Satterfield S, Ferrucci L, Metti AL, Patel KV et al.. Neurology, 2013-07-31
Topic: Risk, prevention and care in population studies
Objective To determine whether anemia is associated with incident dementia in older adults. Methods We studied 2,552 older adults (mean age 76.1 years; 38.9% black; 51.8% female) participating in the Health, Aging, and Body Composition study and free of dementia at baseline. We defined anemia using WHO criteria (hemoglobin concentration Results Of 2,552 participants, 393 (15.4%) older adults had anemia at baseline [corrected]. Over 11 years of follow-up, 455 (17.8%) participants developed dementia. In the unadjusted model, those with baseline anemia had an increased risk of dementia (23% vs. 17%, hazard ratio = 1.64; 95% confidence interval 1.30, 2.07) compared to those without anemia. The association remained significant after adjusting for demographics, APOE ε4, baseline 3MS score, comorbidities, and renal function. Additional adjustment for other anemia measures (mean corpuscular volume, red cell distribution width), erythropoietin, and C-reactive protein did not appreciably change the results. There was no interaction by sex and race on risk of developing dementia. Conclusion Among older adults, anemia is associated with an increased risk of developing dementia. Findings suggest that further study of anemia as a risk factor for dementia and a target for intervention for cognitive health is warranted.
Key findings
- Objective To determine whether anemia is associated with incident dementia in older adults.
- We defined anemia using WHO criteria (hemoglobin concentration Results Of 2,552 participants, 393 (15.4%) older adults had anemia at baseline [corrected].
- In the unadjusted model, those with baseline anemia had an increased risk of dementia (23% vs. 17%, hazard ratio = 1.64; 95% confidence interval 1.30, 2.07) compared to those without anemia.
- The association remained significant after adjusting for demographics, APOE ε4, baseline 3MS score, comorbidities, and renal function.
- Additional adjustment for other anemia measures (mean corpuscular volume, red cell distribution width), erythropoietin, and C-reactive protein did not appreciably change the results.
Why it matters
In this study of older adults free of dementia at baseline, anemia was associated with an increased risk of developing dementia over 11 years, even after adjusting for other factors. This identifies anemia as a possible risk factor that warrants further study; it does not show that treating anemia prevents dementia.
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Study details
- Participants2,552
- Effect size38.9%; 51.8%; 15.4%
- Evidence strengthLow
How this study scored 61/100
Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,552 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 | 5 / 7 | Cited 229 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 15.3 citations a year over 15 year(s) since 2013 |
| Impact for its field and year | 4 / 6 | Cited 8.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 2 / 4 | Cited 48 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Kristine S. Yaffe: h-index 155 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23902706) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 61 / 100 | — |
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Read the original
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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
Hong, C. H., Falvey, C., Harris, T. B., Simonsick, E. M., Satterfield, S., Ferrucci, L., et al. (2013). Anemia and risk of dementia in older adults: findings from the Health ABC study. Neurology. https://doi.org/10.1212/wnl.0b013e31829e701d
Vancouver
Hong CH, Falvey C, Harris TB, Simonsick EM, Satterfield S, Ferrucci L, et al. Anemia and risk of dementia in older adults: findings from the Health ABC study. Neurology. 2013. doi:10.1212/wnl.0b013e31829e701d. PMID: 23902706.
BibTeX
@article{hong2013-23902706,
author = {Hong, C. H. and Falvey, C. and Harris, T. B. and Simonsick, E. M. and Satterfield, S. and Ferrucci, L. and Metti, A. L. and Patel, K. V. and others},
title = {{Anemia and risk of dementia in older adults: findings from the Health ABC study}},
journal = {Neurology},
year = {2013},
doi = {10.1212/wnl.0b013e31829e701d},
pmid = {23902706},
url = {https://doi.org/10.1212/wnl.0b013e31829e701d}
}
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