Skip to main content
Log in

Iron deficiency can cause cognitive impairment in geriatric patients

  • Iron Deficiency Can Cause Cognitive Impairment in Geriatric Patients
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Deficiency of iron, which plays an important role in oxygen transport and storage, may lead to cerebral hypoxia and cognitive decline. This relationship which was studied in children and adults was not evaluated in the elderly. The objective of this study is to examine the effect of iron deficiency on cognitive function in the elderly.

Design, Setting, Participants

This is a cross-sectional study conducted in a geriatric medicine outpatient clinic of a university hospital. Consecutive 2009 patients admitted to Geriatric Medicine outpatient clinic were examined and 622 patients who fulfilled the inclusion criteria were enrolled in the study.

Measurements

Comprehensive geriatric assessment, cognitive assessment and laboratory analysis including blood count, iron, total iron binding capacity, ferritin, and transferrin saturation were performed.

Results

Mean age of the study group was 72.5±6.5 and 439 (70.6%) were women. MMSE scores were moderately and significantly correlated with iron levels (r=0.33, p<0.001) and transferrin saturation (r=0.32, p<0.001). Transferrin saturation was significantly lower in the patients with dementia (p=0.040). It was found that patients with iron deficiency had lower MMSE scores (p<0.001) and this relationship was also present in patients without anemia (p=0.004).

Conclusion

The results of this study revealed a negative influence of iron deficiency on cognitive function and this influence was independent from the presence of anemia. As iron deficiency can be easily diagnosed and treated, detecting its effect on cognitive function is of importance. Screening for iron deficiency and initiating appropriate treatment should be a routine part of comprehensive geriatric assessment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Guralnik JM, Eisenstaedt RS, Ferrucci L, et al. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004;104:2263–2268.

    Article  PubMed  CAS  Google Scholar 

  2. Murray-Kolb, Beard JE. Iron treatment normalizes cognitive functioning in young women. Am J Clin Nutr 2007;85:778–787.

    PubMed  CAS  Google Scholar 

  3. Petranovic D, Batinac T, Petranovic D, et al. Iron deficiency anaemia influences cognitive functions. Med Hypotheses 2008; 70: 70–72.

    Article  PubMed  CAS  Google Scholar 

  4. Demetri GD. Anaemia and its functional consequences in cancer patients: current challenges in management and prospects for improving therapy. Br J Cancer 2001;84(Suppl. 1):31–37.

    Article  PubMed  CAS  Google Scholar 

  5. Agaoglu L, Torun O, Unuvar E, et al. Effects of iron deficiency anemia on cognitivefunction in children. Arzneimittelforschung. 2007;57(6A):426–430.

    PubMed  CAS  Google Scholar 

  6. Lozoff B, Klein NK, Nelson EC, et al. Behaviour of infants with iron-deficiency anemia. Child Dev 1998;69:24–36.

    PubMed  CAS  Google Scholar 

  7. Peters R, Burch L, Warner J, Beckett N, Poulter R, Bulpitt C. Haemoglobin, anaemia, dementia and cognitive decline in the elderly, a systematic review. BMC Geriatrics 2008; 8: 18.

    Article  PubMed  Google Scholar 

  8. Lipschitz D. Medical and Functional Consequences of Anemia in the Elderly. J AmGeriatr Soc 2003;51(Suppl 3):S10–S13.

    Article  Google Scholar 

  9. Yavuz BB. Influence of iron deficiency on cognitive functions in the elderly, Hacettepe University Faculty of Medicine, Thesis in Geriatric Medicine. Ankara, 2009.

  10. Molloy DW, Standish TI. A guide to the standardized Mini-Mental State Examination. Int Psychogeriatr. 1997;9Suppl 1:87–94.

    Article  PubMed  Google Scholar 

  11. Stahelin HB, Monsch AU, Spiegel R. Early diagnosis of dementia via a two-step screening and diagnostic procedure. International Psychogeriatrics 1997;9:123–130.

    Article  PubMed  Google Scholar 

  12. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Washington: American Psychiatric Association, 1994.

    Google Scholar 

  13. McKhann, G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34: 939–944.

    PubMed  CAS  Google Scholar 

  14. Adamson JW. Iron deficiency and other hypoproliferative anemias. In: Fauci AS, Braunwald E, Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine, 17thed. USA: McGraw-Hill, 2008, pp628–634.

    Google Scholar 

  15. Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006;10:377–385.

    PubMed  CAS  Google Scholar 

  16. Chaves PH, Carlson MC, Fried LP. Cognitive function in high functioning older women: does hemoglobin concentration matter. J Am Geriatr Soc 2002;50(Suppl 4): S149–S150.

    Google Scholar 

  17. Hidalgo C, Nunez MT. Calcium, Iron and Neuronal Function. IUBMB Life 2007;59:280–285.

    Article  PubMed  CAS  Google Scholar 

  18. Grantham-McGregor, S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr 2001; 131: 649S–666S.

    PubMed  CAS  Google Scholar 

  19. Pollitt, E. Timing and vulnerability in research on malnutrition and cognition. NutrRev 1996;54: S49–S55.

    CAS  Google Scholar 

  20. Burden MJ, Westerlund AJ, Armony-Sivan R, et al. An Event-Related Potential Study of Attention and Recognition Memory in Infants With Iron-Deficiency Anemia. Pediatrics 2007;120:e336–e345.

    Article  PubMed  Google Scholar 

  21. Lubach GR, Coe CL. Selective impairment of cognitive performance in the young monkey following recovery from iron deficiency. J Dev Behav Pediatr 2008;29:11–17.

    PubMed  Google Scholar 

  22. Lozoff B. Iron deficiency and child development. Food Nutr Bull 2007;28(4Suppl):S560–S571.

    PubMed  Google Scholar 

  23. Gera T, Sachdev HPS. Iron Supplementation for Improving Mental Development. Indian Pediatrics 2009;46:125–126.

    PubMed  Google Scholar 

  24. Evans RW, Rader B, Manninen DL. The quality of life of hemodialysis recipients treated with recombinant human erythropoietin. Cooperative Multicenter EPO ClinicalTrial Group. JAMA 1990;263:825–830.

    Article  PubMed  CAS  Google Scholar 

  25. Groner JA, Holtzman NA, Charney E, et al. A randomized trial of oral iron on tests of short-term memory and attention span in young pregnant women. J Adolesc Health Care 1986;7:44–48.

    Article  PubMed  CAS  Google Scholar 

  26. Cunningham RS. Anemia in the oncology patient: cognitive function and cancer. Cancer Nurs. 2003 Dec;26:38S–42S.

    Article  PubMed  Google Scholar 

  27. Zamboni V, Cesari M, Zuccala G, et al. Anemia and cognitive performance in hospitalized older patients: results from the GIFA study. Int J Geriatr Psychiatry 2006, 21:529–534.

    Article  PubMed  Google Scholar 

  28. Argyriadou S, Vlachonikolis I, Melisopoulou H, et al. In what extent anemia coexists with cognitive impairment in elderly: A cross-sectional study in Greece. BMC Fam Pract 2001;2:5.

    Article  PubMed  CAS  Google Scholar 

  29. Crawford J, Cella D, Cleeland CS. Relationship between changes in hemoglobin level and quality of life during chemotherapy in anemic cancer patients receiving epoetin alfa therapy. Cancer 2002;95:888–895.

    Article  PubMed  CAS  Google Scholar 

  30. Holzner B, Kemmler G, Greil P, et al. The impact of hemoglobin levels on fatigue and quality of life in cancer patients. Ann Oncol 2002;13:965–973.

    Article  PubMed  CAS  Google Scholar 

  31. Meyers CA, Wefel JS. The use of the mini-mental state examination to assess cognitive functioning in cancer trials: no ifs, ands, buts, or sensitivity. J Clin Oncol 2003;21:3557–3558.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Burcu Balam Yavuz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yavuz, B.B., Cankurtaran, M., Haznedaroglu, I.C. et al. Iron deficiency can cause cognitive impairment in geriatric patients. J Nutr Health Aging 16, 220–224 (2012). https://doi.org/10.1007/s12603-011-0351-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-011-0351-7

Key words

Navigation