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ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1571159
This article is part of the Research Topic Blood, Cerebrospinal Fluid, and Vascular Biomarkers for Dementia View all 16 articles
Association between hemoglobin-to-red blood cell distribution width ratio and cognitive function in Older US Adults: a cross-sectional study based on the NHANES 2011-2014
Provisionally accepted
FAN WANG 1,2,3
XIANGYANG WANG 4 CHAOWEI WANG 3 HAO LIU 3
Zhixiu Xu 3
DONGLI LI 3 XIAOWEN ZHAO 5 JIALU ZHAO 6 SHAOMIN LI 7 JIANHUA ZHAO 1,3,8*- 1 Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia,, XINXIANG, China
- 2 Henan Key Laboratory of Neurorestoratology and protein modification, XINXIANG, China
- 3 Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xin xiang, Henan Province, China
- 4 Department of neurosurgery, First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453100, China；, XINXIANG, China
- 5 Fujian Medical University，Fuzhou,Fujian,350000, China；, Fuzhou,Fujian, China
- 6 Xinxiang Medical University, Xinxiang, Henan, 453100, China, XINXIANG, China
- 7 Ann Romney Center for Neurologic Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States, Boston, United States
- 8 Henan Key Laboratory of Neurorestoratology and protein modification,, XINXIANG, China
The hemoglobin-to-red blood cell distribution width ratio (HRR) is acknowledged as a promising new prognostic biomarker. Nevertheless, investigations into its connection with cognitive function have yielded unclear results.This study aimed to investigate the association between the hemoglobin-to-red blood cell distribution width ratio (HRR) and cognitive function in older adults in the United States.This study utilized data obtained from the NHANES database, encompassing the years 2011 to 2014. The participant cohort consisted of elderly individuals aged 60 years and older, all of whom underwent thorough assessments of cognitive function, hemoglobin levels, and red blood cell width. We employed weighted logistic regression analysis, along with restricted cubic spline (RCS) curves and subgroup analyses, to rigorously evaluate the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and cognitive function.This study encompassed a total of 2,520 participants, with a mean age of 69.44 ± 6.76 years. After adjusting for multiple covariates, logistic regression analysis indicated a significant linear cognitive impairment between HRR and cognitive function. Specifically, each one-unit increase in HRR was associated with an 82% reduction in the probability of cognitive impairment among participants ( OR = 0.18, 95% CI: 0.04-0.78).This relationship remained exist after HRR was categorized into tertiles.Participants in the highest HRR tertile exhibited a 42% lower likelihood of cognitive impairment compared to those in the lowest tertile (OR = 0.58;95% CI: 0.37-0.91, p = 0.022). To validate the robustness of our findings, we conducted subgroup analyses, which consistently demonstrated stable results across all evaluated groups.This cross-sectional study revealed a significant negative correlation between HRR and cognitive function.
Keywords: Hemoglobin, Red cell distribution width, Hemoglobin-to-red blood cell distribution width ratio, Cognitive Function, NHANES, including age, gender, Genetics
Received: 05 Feb 2025; Accepted: 24 Mar 2025.
Copyright: © 2025 WANG, WANG, WANG, LIU, Xu, LI, ZHAO, ZHAO, LI and ZHAO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
JIANHUA ZHAO, Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia,, XINXIANG, China
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