Sickle cell trait and risk of cognitive impairment in African-Americans: The REGARDS cohort.
Cognition
Cognitive dysfunction
Epidemiology
Prospective studies
Risk factors
Sickle cell trait
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Historique:
received:
14
10
2018
revised:
02
05
2019
accepted:
03
05
2019
entrez:
18
7
2019
pubmed:
18
7
2019
medline:
18
7
2019
Statut:
epublish
Résumé
Sickle cell anemia may be associated with cognitive dysfunction, and some complications of sickle cell anemia might affect those with sickle cell trait (SCT), so we hypothesized that SCT is a risk factor for cognitive impairment. The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled a national cohort of 30,239 white and black Americans from 2003 to 7, who are followed every 6 months. Baseline and annual global cognitive function testing used the Six-Item Screener (SIS), a validated instrument (scores range 0-6; ≤ 4 indicates cognitive impairment). Participants with baseline cognitive impairment and whites were excluded. Logistic regression was used to calculate the association of SCT with incident cognitive impairment, adjusted for risk factors. Linear mixed models assessed multivariable-adjusted change in test scores on a biennially administered 3-test battery measuring learning, memory, and semantic and phonemic fluency. Among 7743 participants followed for a median of 7·1 years, 85 of 583 participants with SCT (14·6%) developed incident cognitive impairment compared to 902 of 7160 (12·6%) without SCT. In univariate analysis, the odds ratio (OR) of incident cognitive impairment was 1·18 (95% CI: 0·93, 1·51) for those with SCT vs. those without. Adjustment did not impact the OR. There was no difference in change on 3-test battery scores by SCT status (all In this prospective cohort study of black Americans, SCT was not associated with incident cognitive impairment or decline in test scores of learning, memory and executive function. National Institutes of Health, American Society of Hematology.
Sections du résumé
BACKGROUND
BACKGROUND
Sickle cell anemia may be associated with cognitive dysfunction, and some complications of sickle cell anemia might affect those with sickle cell trait (SCT), so we hypothesized that SCT is a risk factor for cognitive impairment.
METHODS
METHODS
The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled a national cohort of 30,239 white and black Americans from 2003 to 7, who are followed every 6 months. Baseline and annual global cognitive function testing used the Six-Item Screener (SIS), a validated instrument (scores range 0-6; ≤ 4 indicates cognitive impairment). Participants with baseline cognitive impairment and whites were excluded. Logistic regression was used to calculate the association of SCT with incident cognitive impairment, adjusted for risk factors. Linear mixed models assessed multivariable-adjusted change in test scores on a biennially administered 3-test battery measuring learning, memory, and semantic and phonemic fluency.
FINDINGS
RESULTS
Among 7743 participants followed for a median of 7·1 years, 85 of 583 participants with SCT (14·6%) developed incident cognitive impairment compared to 902 of 7160 (12·6%) without SCT. In univariate analysis, the odds ratio (OR) of incident cognitive impairment was 1·18 (95% CI: 0·93, 1·51) for those with SCT vs. those without. Adjustment did not impact the OR. There was no difference in change on 3-test battery scores by SCT status (all
INTERPRETATION
CONCLUSIONS
In this prospective cohort study of black Americans, SCT was not associated with incident cognitive impairment or decline in test scores of learning, memory and executive function.
FUNDING
BACKGROUND
National Institutes of Health, American Society of Hematology.
Identifiants
pubmed: 31312804
doi: 10.1016/j.eclinm.2019.05.003
pii: S2589-5370(19)30077-X
pmc: PMC6610762
doi:
Types de publication
Journal Article
Langues
eng
Pagination
27-33Subventions
Organisme : NHLBI NIH HHS
ID : K08 HL125100
Pays : United States
Organisme : NIMHD NIH HHS
ID : L60 MD013112
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS041588
Pays : United States
Références
Am J Hematol. 2002 Feb;69(2):89-94
pubmed: 11835343
Blood. 2002 Apr 15;99(8):3014-8
pubmed: 11929794
Med Care. 2002 Sep;40(9):771-81
pubmed: 12218768
J Pediatr Psychol. 2002 Dec;27(8):739-48
pubmed: 12403864
Radiology. 2003 Jul;228(1):208-15
pubmed: 12759471
Am J Hum Genet. 1965 Mar;17:101-3
pubmed: 14262126
J Pediatr Psychol. 2004 Dec;29(8):627-33
pubmed: 15491985
AJNR Am J Neuroradiol. 2005 Mar;26(3):455-62
pubmed: 15760849
Neuroepidemiology. 2005;25(3):135-43
pubmed: 15990444
Arch Neurol. 2005 Nov;62(11):1778-9
pubmed: 16286556
Arch Neurol. 2005 Nov;62(11):1780-1
pubmed: 16286557
Nat Genet. 2006 Aug;38(8):904-9
pubmed: 16862161
Blood. 2007 Aug 1;110(3):908-12
pubmed: 17409269
Vasc Health Risk Manag. 2008;4(2):363-81
pubmed: 18561512
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Blood. 2009 Dec 10;114(25):5117-25
pubmed: 19797523
Neurology. 1991 Apr;41(4):479-86
pubmed: 2011243
Am J Geriatr Psychiatry. 2010 Sep;18(9):801-9
pubmed: 20220577
NIH Consens State Sci Statements. 2010 Apr 28;27(4):1-30
pubmed: 20445638
JAMA. 2010 May 12;303(18):1823-31
pubmed: 20460621
Neurology. 2011 Nov 8;77(19):1729-36
pubmed: 22067959
Maturitas. 2013 Oct;76(2):113-7
pubmed: 23849703
Paediatr Respir Rev. 2014 Mar;15(1):17-23
pubmed: 24461342
Neurology. 2014 Mar 11;82(10):835-41
pubmed: 24523480
Neuropsychol Rev. 2014 Jun;24(2):252-65
pubmed: 24744195
Alzheimer Dis Assoc Disord. 2015 Jan-Mar;29(1):18-25
pubmed: 24787033
Clin Biochem. 2014 Nov;47(16-17):243-6
pubmed: 25130959
Stroke. 2014 Oct;45(10):2863-7
pubmed: 25139879
Br J Haematol. 2015 Feb;168(4):553-6
pubmed: 25303108
JAMA. 2014 Nov 26;312(20):2115-25
pubmed: 25393378
J Thromb Haemost. 2015 Jan;13(1):2-9
pubmed: 25393788
JAMA. 2015 Jul 7;314(1):41-51
pubmed: 26151265
Thromb Res. 2016 Mar;139:44-9
pubmed: 26916295
Blood. 2016 May 5;127(18):2261-3
pubmed: 26968536
Dev Med Child Neurol. 2016 Jul;58(7):672-9
pubmed: 27038278
Am J Med. 1989 Jul;87(1):48-56
pubmed: 2741981
J Alzheimers Dis. 2016 Sep 6;54(2):497-503
pubmed: 27567834
Neurology. 1989 Sep;39(9):1159-65
pubmed: 2771064
PLoS One. 2017 Feb 16;12(2):e0172659
pubmed: 28207871
J Am Soc Nephrol. 2017 Jul;28(7):2180-2187
pubmed: 28280138
JAMA Neurol. 2018 Jul 1;75(7):802-807
pubmed: 29710269
Neurology. 2018 Jun 5;90(23):e2042-e2050
pubmed: 29752305
N Engl J Med. 1979 May 3;300(18):1001-5
pubmed: 431593
Blood. 1998 Jan 1;91(1):288-94
pubmed: 9414296