Association of Red Blood Cell Indices with Mild Cognitive Impairment in Chinese Elderly Individuals: A Matched Case-control Study

Title:Association of Red Blood Cell Indices with Mild Cognitive Impairment in Chinese Elderly Individuals: A Matched Case-control Study

Volume: 17 Issue: 13

Author(s): Yue Du , Mengdi Jin, Qian Liu, Jiangang Zhao, Aili Song , Wen Li , Hong Chang, Fei Ma*Guowei Huang *

Affiliation:

• Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin,China

• Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin,China

Keywords: Mild cognitive impairment, elderly, biomarker, ROC curve, matched case-control study, dementia.

Abstract:

Background: Mild cognitive impairment (MCI) represents an intermediate and modifiable stage between normal aging and dementia. There is an urgent need for simple, non-invasive testing of MCI by blood biomarkers.

Objective: This study aimed to retrospectively evaluate the association of red blood cell (RBC) indices with MCI, and select the best hematologic characteristic for detection of MCI in elderly Chinese.

Methods: Matched case-control study was carried out with 85 pairs of MCI subjects and healthy controls. The matching criteria was age, gender and education attainment. All samples were analyzed for RBC indices, including hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width-standard deviation (RDW-SD). A conditional logistic regression model was used to evaluate the association between RBC indices and MCI. The diagnostic efficacy of the biomarkers was evaluated by receiver operating characteristics (ROC).

Results: Among all RBC indices, there were significant differences in HGB (124.82 ± 7.89 vs. 133.93 ± 4.52, P < 0.001) and RDW-SD (45.29 ± 2.03 vs. 41.34 ± 4.41, P < 0.001) between two groups. In the logistic regression model, after adjustment for lifestyle factors and comorbidities, significant statistically associations have been found between higher HGB and lower risk of MCI (adjusted OR: 0.831; 95% CI: 0.773-0.893), higher RDW-SD and a higher risk of MCI (adjusted OR: 1.575; 95% CI: 1.326- 1.872). ROC analysis suggested that the largest area under the ROC curve (AUC) was found with the combination of HGB and RDW-SD (AUC = 0.842), followed by HGB(AUC = 0.795), and finally by modest RDW-SD (AUC = 0.777). Combination of HGB <131 g/L and RDW-SD >43.4 fL yielded a sensitivity of 92% and a specificity of 89%, overall diagnosis efficiency of which were better than HBG and RDW-SD alone.

Conclusion: Lower HGB and higher RDW-SD alone were significantly found to be associated with increased risk of MCI, and offered modest sensitivity and specificity as a diagnostic marker. The combination of HGB and RDW-SD was more sensitive and had higher classification accuracy for differentiating MCI from healthy controls. Further prospective research is needed to clarify whether HGB in combination with RDW-SD may be a potential diagnostic tool for early diagnosis of AD.

Cite this article as:

Du Yue , Jin Mengdi, Liu Qian, Zhao Jiangang, Song Aili, Li Wen , Chang Hong , Ma Fei*, Huang Guowei *, Association of Red Blood Cell Indices with Mild Cognitive Impairment in Chinese Elderly Individuals: A Matched Case-control Study, Current Alzheimer Research 2020; 17 (13) . https://dx.doi.org/10.2174/1567205018666210218144856