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<p>An elevated risk of dementia among anemic population has been reported in previous studies. However, measurement on the risk of individual subtypes of dementia has been limited. We aimed to quantify risk of dementia and its subtypes in the general population with anemia, using Korean National Health Insurance Service data linked to biennial national health check-ups. We conducted a cohort study on propensity-score fine-stratification (PSS)-weighted 50,008 anemic and 992,497 non-anemic participants aged ≥ 60 years who underwent three consecutive check-ups during 2006–2011. Anemia was defined as hemoglobin levels (Hb) &lt;12&#xa0;g/dL (females) or &lt; 13&#xa0;g/dL (males) and non-anemia as levels above the cut-offs at all three check-ups, requiring chronicity of low Hb. The primary outcome was incident dementia. Secondary outcomes included Alzheimer’s disease (AD) and vascular dementia (VD). We estimated PSS-weighted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models. Dose-responsive (Hb ≥ 10&#xa0;g/dL as mild, &lt; 10&#xa0;g/dL as moderate-to-severe) and subgroup (age, sex, income, diabetes, and cardiovascular disease at baseline) analyses were done. Over 11.8 years on average, 430,161 dementia cases developed with a HR (95% CI) of 1.09 (1.08–1.11) for dementia, 1.10 (1.08–1.11) for AD, and 1.04 (1.01–1.07) for VD. The risk of dementia was higher for moderate-to-severe anemia (HR 1.20, 95% CI 1.15–1.26) than mild anemia (HR 1.09, 95% CI 1.08 − 1.10) versus non-anemia. The association was consistent across subgroups, being greater in males than females (p for interaction &lt; 0.05, HR 1.14, 95% CI 1.12–1.17 in males, HR 1.07, 95% CI 1.05–1.09 in females). This large population-based cohort study shows that the risk of dementia associated with persistent anemia was greater for AD than VD, of which association was dose-responsive and affected by sex.</p>

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Anemia and risk of dementia in the general population: a propensity-score based cohort study

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  • 发表日期：

    2026年7月3日

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  • Eun Ha Kang,
  • Se Rim Choi,
  • Anna Shin,
  • Minji Han,
  • Eun Bong Lee

摘要

An elevated risk of dementia among anemic population has been reported in previous studies. However, measurement on the risk of individual subtypes of dementia has been limited. We aimed to quantify risk of dementia and its subtypes in the general population with anemia, using Korean National Health Insurance Service data linked to biennial national health check-ups. We conducted a cohort study on propensity-score fine-stratification (PSS)-weighted 50,008 anemic and 992,497 non-anemic participants aged ≥ 60 years who underwent three consecutive check-ups during 2006–2011. Anemia was defined as hemoglobin levels (Hb) <12 g/dL (females) or < 13 g/dL (males) and non-anemia as levels above the cut-offs at all three check-ups, requiring chronicity of low Hb. The primary outcome was incident dementia. Secondary outcomes included Alzheimer’s disease (AD) and vascular dementia (VD). We estimated PSS-weighted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models. Dose-responsive (Hb ≥ 10 g/dL as mild, < 10 g/dL as moderate-to-severe) and subgroup (age, sex, income, diabetes, and cardiovascular disease at baseline) analyses were done. Over 11.8 years on average, 430,161 dementia cases developed with a HR (95% CI) of 1.09 (1.08–1.11) for dementia, 1.10 (1.08–1.11) for AD, and 1.04 (1.01–1.07) for VD. The risk of dementia was higher for moderate-to-severe anemia (HR 1.20, 95% CI 1.15–1.26) than mild anemia (HR 1.09, 95% CI 1.08 − 1.10) versus non-anemia. The association was consistent across subgroups, being greater in males than females (p for interaction < 0.05, HR 1.14, 95% CI 1.12–1.17 in males, HR 1.07, 95% CI 1.05–1.09 in females). This large population-based cohort study shows that the risk of dementia associated with persistent anemia was greater for AD than VD, of which association was dose-responsive and affected by sex.