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An anemia of Alzheimer's disease


Lower hemoglobin is associated with cognitive impairment and Alzheimer's disease (AD). Since brain iron homeostasis is perturbed in AD, we investigated whether this is peripherally reflected in the hematological and related blood chemistry values from the Australian Imaging Biomarker and Lifestyle (AIBL) study (a community-based, cross-sectional cohort comprising 768 healthy controls (HC), 133 participants with mild cognitive impairment (MCI) and 211 participants with AD). We found that individuals with AD had significantly lower hemoglobin, mean cell hemoglobin concentrations, packed cell volume and higher erythrocyte sedimentation rates (adjusted for age, gender, APOE-ɛ4 and site). In AD, plasma iron, transferrin, transferrin saturation and red cell folate levels exhibited a significant distortion of their customary relationship to hemoglobin levels. There was a strong association between anemia and AD (adjusted odds ratio (OR)=2.43, confidence interval (CI) (1.31, 4.54)). Moreover, AD emerged as a strong risk factor for anemia on step-down regression, even when controlling for all other available explanations for anemia (adjusted OR=3.41, 95% CI (1.68, 6.92)). These data indicated that AD is complicated by anemia, which may itself contribute to cognitive decline.

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Core funding for the study was provided by CSIRO, which was supplemented by in-kind contributions from the study partners (see The research was also supported by the Science Industry and Endowment Fund (see, the Cooperative Research Center for Mental Health, and the National Health and Medical Research Council (NHMRC) via the Dementia Collaborative Research Centres program (DCRC2). The Florey Institute acknowledges the funding support from the Victorian Government’s Operational Infrastructure Support program. NGF is supported by a NHMRC training fellowship. AIB is supported by NHMRC Australia Fellowship. Pfizer International has contributed financial support to assist with analysis of blood samples and to further the AIBL research program. The McCusker Foundation has contributed financial and in-kind support to AIBL. Alzheimer’s Australia (Victoria and Western Australia) assisted with promotion of the study and the screening of telephone calls from volunteers. The AIBL team thanks the following clinicians who referred patients with AD and/or MCI to the study: Associate Professor Brian Chambers, Professor Edmond Chiu, Dr Roger Clarnette, Associate Professor David Darby, Dr Mary Davison, Dr John Drago, Dr Peter Drysdale, Dr Jacqui Gilbert, Dr Kwang Lim, Professor Nicola Lautenschlager, Dr Dina LoGiudice, Dr Peter McCardle, Dr Steve McFarlane, Dr Alastair Mander, Dr John Merory, Professor Daniel O’Connor, Dr Ron Scholes, Dr Mathew Samuel, Dr Darshan Trivedi, Dr Peter Panegyres and Associate Professor Michael Woodward.

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Correspondence to A I Bush.

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AIB and CLM are shareholders in Prana Biotechnology Limited. AIB is a shareholder in Cogstate Limited and Mesoblast Limited.

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Faux, N., Rembach, A., Wiley, J. et al. An anemia of Alzheimer's disease. Mol Psychiatry 19, 1227–1234 (2014).

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  • alzheimer's disease
  • anemia
  • folate
  • hematology
  • hemoglobin
  • iron

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