Red Cell Distribution Width Is Directly Associated with Poor Cognitive Performance among Nonanemic, Middle-Aged, Urban Adults
Red Cell Distribution Width Is Directly Associated with Poor Cognitive Performance among Nonanemic, Middle-Aged, Urban Adults
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DOI：
10.1093/jn/nxz182
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发表时间：
2020-01-01
影响因子：
4.2
通讯作者：
Zonderman, Alan B.
中科院分区：
文献类型：
--
作者：
Beydoun, May A.;Hossain, Sharmin;Zonderman, Alan B.
背景：流行病学证据表明，贫血和红细胞分布宽度(RDW)升高都与认知障碍有关。然而，这两个预测因素之间的相互作用一直没有得到充分的研究。目的：我们在美国城市成年人中检验了特定性别和贫血的RDW与认知表现之间的关联。方法：使用了跨寿命社区健康老龄化研究的数据(马里兰州巴尔的摩；基线年龄为30-65岁的参与者，类似于59%的非裔美国人，45%的男性)。参与者是根据基线(2004-2009年)完成11项认知任务和随访(2009-2013年)访问(平均访问间隔时间：4.64+/-0.93y)以及暴露和协变量数据的可获得性来选择的，从基线招募的最初3720名成年人中产生了1526至1646名成年人。以RDW为主要兴趣暴露，以贫血/性别为主要影响因素，建立多元线性混合效应回归模型。结果：总体来看，RDW越高，在加州语言学习测试(CVLT)A表上的基线成绩越差(RDW%每单位增加1个单位，主效应：01=-0.369+/-0.114；P=0.001)，以及CVLT延迟自由召回的下降速度较慢(每增加1个单位，RDW%，RDWx时间：。11=+0.036+/-0.013；P=0.007)。在非贫血参与者中，RW与A部分的基线表现较差(Gamma(01)=+3.11+/-0.89；P<；0.001)和CVLT列表A(Gamma(01)=-0.560+/-0.158；P<；0.001)一致相关。此外，在总体人群(GAMA(01)=-0.123+/-0.039；P=0.001)和男性(GAMA(01)=-0.221+/-0.068；P=0.001)中，RW与简明注意力测试的基线表现较差有关。我们没有发现血红蛋白(Hb)与基线认知表现或随时间的变化之间的关联。结论：在中年城市成年人样本中，RDW升高与非贫血组在言语记忆和注意力领域的认知表现差存在一致的横截面关联。贫血和Hb浓度与认知能力无关。需要更多的纵向研究来重复我们的发现。
Background: Epidemiological evidence suggests that both anemia and elevated red cell distribution width (RDW) are associated with cognitive impairment. However, the interplay between these 2 predictors has been understudied.Objectives: We examined sex- and anemia-specific associations between RDW and cognitive performance among urban adults in the United States.Methods: Data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study (Baltimore, MD; participants aged 30-65 y at baseline, similar to 59% African-American, 45% men) were used. Participants were selected based on the completion of 11 cognitive tasks at baseline (2004-2009) and follow-up (2009-2013) visits (mean time between visits: 4.64 +/- 0.93 y) and availability of exposure and covariate data, yielding a sample of between 1526 and 1646 adults out of the initial 3720 adults recruited at baseline. Multiple linear mixed-effects regression models were conducted with RDW as the main exposure of interest and anemia/sex as the key effect modifiers.Results: Overall, high RDWs were linked to poorer baseline performance on the California Verbal Learning Test (CVLT) List A (per 1 unit increase in RDW %, main effect:. 01 =-0.369 +/- 0.114; P = 0.001) and to slower rates of decline on the CVLT Delayed Free Recall (per 1 unit increase in RDW %, RDW x time:. 11 = +0.036 +/- 0.013; P = 0.007). Among nonanemic participants, RDWs were consistently associated with poorer baseline performance on the Trailmaking Test, Part A (gamma(01) =+3.11 +/- 0.89; P < 0.001) and on the CVLT List A (gamma(01) =-0.560 +/- 0.158; P < 0.001). Moreover, RDWs were associated with poorer baseline performance on the Brief Test of Attention in the total population (gamma(01) =-0.123 +/- 0.039; P = 0.001) and among men (gamma(01) =-0.221 +/- 0.068; P = 0.001). We did not detect an association between hemoglobin (Hb) and baseline cognitive performance or changes over time.Conclusions: Elevated RDW had a consistent cross-sectional association with poor cognitive performance in the domains of verbal memory and attention among the nonanemic group in a sample of middle-aged, urban adults. Anemia and Hb concentrationswere not associated with cognition. More longitudinal studies are needed to replicate our findings.