TL;DR
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A study tracking 316,542 South Korean adults found that hemoglobin levels measured during routine health screening were associated with dementia diagnoses recorded over as many as 15 years. The observational findings do not show that hemoglobin causes dementia or that changing its level would prevent it.
A study of 316,542 South Korean adults found that hemoglobin levels recorded in routine health screenings were associated with dementia diagnoses over up to 15 years of follow-up. The findings, presented at the 39th ECNP Congress and published in the Journal of Alzheimer’s Disease, suggest the common blood-test measure could be a clue to long-term risk, but do not show it causes dementia or can predict an individual’s outcome.
Researchers used screening data collected in 2004 and 2005 from adults aged 40 and older, then checked national health insurance records for new dementia diagnoses through the end of 2019. They divided participants into five groups according to hemoglobin level, from the lowest fifth to the highest fifth. Hemoglobin is the protein in red blood cells that carries oxygen around the body.
Compared with the group with the lowest dementia rate, people in the lowest hemoglobin fifth had a 16% higher risk of all-cause dementia; those in the highest fifth had a 7% higher risk. The pattern varied by diagnosis. For Alzheimer’s disease, the increased risk was mainly among participants in the lowest fifth, at 14% above the reference group. For vascular dementia, the lowest fifth had a 19% higher risk and the highest fifth an 18% higher risk. The relationship for vascular dementia did not follow a simple pattern across all five groups.
The association was clearer and more consistent in women than in men, according to the research report. The study does not provide evidence that changing hemoglobin levels would reduce dementia risk. Its results describe associations within this cohort, not a diagnostic test or a treatment recommendation.
What Routine Screening Could Reveal
Hemoglobin is already measured in many standard blood tests, making the finding of interest to researchers looking for accessible ways to study links between overall health and brain health. Unlike specialist brain scans or newer laboratory markers, the result may already be available in routine medical records. That could help researchers investigate whether broader patterns in physical health are associated with dementia years later.
But a routine measure is not automatically a useful individual prediction tool. The study reports differences in risk between groups; it does not establish how accurately a hemoglobin result can forecast dementia for one person. Nor does it show that a clinician should treat a result differently to prevent dementia. Any possible value for prediction or prevention would require further study.
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How the Korean Cohort Was Tracked
The research was based on a large national cohort: participants had a health screening in 2004–2005, and researchers followed new diagnoses in insurance records for up to 15 years. This long follow-up let the team examine whether screening measurements were associated with diagnoses recorded later. It remains an observational design: the researchers compared existing health information rather than assigning participants to interventions.
Low hemoglobin is commonly associated with anemia. Unusually high levels can reflect several possible factors, including smoking, dehydration, lung or heart disease, or other medical conditions. These possibilities matter because hemoglobin may be a marker of wider health or vulnerability rather than a direct cause of changes in the brain.
The study was presented at the European College of Neuropsychopharmacology Congress in Munich and published in the Journal of Alzheimer’s Disease. External comment from Dr Lindsey Sinclair of the University of Southampton emphasized that more research is needed to test whether the association applies across people with different backgrounds and to understand what, if anything, can reduce risk for people at either end of the hemoglobin range.
“The findings do not show that hemoglobin itself causes dementia, but suggest that abnormal hemoglobin levels may be a visible marker of wider physical vulnerability relevant to brain health.”
— Dr Hyun Soo Kim, lead researcher and assistant professor at Dong-A University College of Medicine
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Limits of the Risk Association
Because the study was observational, it cannot establish that low or high hemoglobin caused dementia. Other health conditions or factors could help explain the association. Researchers also raised the possibility that early, undiagnosed dementia processes could affect nutrition, frailty, weight loss, or anemia before a formal diagnosis, complicating the direction of the relationship.
The findings come from adults in South Korea, and it is not yet clear whether the pattern would be similar in populations with different backgrounds. The report also does not establish a hemoglobin threshold that can reliably identify a person’s future dementia risk, or show whether using the measure improves care. No intervention was tested.
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Research Needed Beyond This Cohort
Further studies will be needed to see whether the association holds in people from a wider range of backgrounds and to clarify how hemoglobin relates to other health conditions and dementia diagnoses. Researchers would also need to test whether the measure adds useful information to existing approaches to assessing risk, rather than simply reflecting other aspects of health.
For now, Dr Kim advised people not to take iron supplements or try to change hemoglobin levels to prevent dementia based on these results. He said an abnormal result should be discussed with a doctor, since it may point to an underlying health issue that warrants attention. The next practical milestone is further research, not a change in routine dementia screening or treatment based on this study alone.
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Key Questions
What did the study find?
Among 316,542 South Korean adults, lower hemoglobin levels were associated with higher rates of later dementia diagnoses. Some associations were also seen for people with the highest levels, particularly for vascular dementia.
Does low hemoglobin cause dementia?
The study does not show that hemoglobin causes dementia. It was observational, so it can identify an association but cannot establish cause and effect.
Should people change their hemoglobin levels to prevent dementia?
No such advice follows from this research. Lead researcher Dr Hyun Soo Kim said the results should not be interpreted as a reason to take iron supplements or to raise or lower hemoglobin for dementia prevention. Discuss an abnormal blood-test result with a doctor.
How long were participants followed?
Participants had health screenings in 2004–2005. Researchers used national health insurance records to track new diagnoses through the end of 2019, giving up to 15 years of follow-up.
Can a routine hemoglobin test predict an individual’s dementia risk?
The study does not establish that it can. It compared dementia rates across groups and did not show that hemoglobin alone can reliably predict what will happen to an individual.
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