Mild anemia may be an independent risk factor for mental impairment in elderly adults ranging from loss of executive function to clinically obvious cognitive impairment, according to an article in the September issue of the Journal of the American Geriatrics Society

“Our work supports the notion that mild anemia may be an independent risk factor for so-called executive-function impairment in older adults,” said Paulo Chaves, MD, PhD, an assistant professor at The Johns Hopkins University School of Medicine and lead author of the study. “If further studies confirm that’s true, this could mean that correction of anemia in these patients might offer a chance to prevent such a cognitive decline.”

Previous studies had shown that age-related declines in the brain’s so-called executive functions, higher-level functions such as problem solving, planning, assessing dangers, and following up on important activities, lead to declines in self-sufficiency.

“Executive function impairment, which happens often before memory loss occurs, may happen early on in the process of becoming unable to carry on with instrumental day-to-day living activities, such as shopping, cooking, taking medications, paying bills, walking, etc.,” said Chaves.

Chaves and his team gave three psychological tests commonly used to evaluate executive function to 364 women, all between 70 and 80 years old, who were living in Baltimore, Maryland. Approximately 10 percent had mild anemia.

Roughly 15 percent of the participants with the worst results on all three tests were anemic, compared with only 3 percent who scored best. Women with anemia were four to five times more likely to perform worst on the executive function tests compared with peers who had normal blood hemoglobin, after taking into account the effect of other factors that affect cognition, such as age, education and existing diseases.

“These preliminary results don’t prove that anemia causes impaired executive function, nor indicate that treatment of anemia would necessarily lead to better executive function,” said Chaves. “However, they are compelling enough to serve as a roadmap for continued research.”