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A study tracking 316,542 South Korean adults found that unusually low hemoglobin levels—and, for some outcomes, unusually high levels—were associated with greater odds of later dementia diagnoses. 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 during routine health screenings were associated with dementia diagnoses up to 15 years later, researchers reported at the 39th ECNP Congress and in the Journal of Alzheimer’s Disease. The findings suggest a familiar blood-test measure could help researchers study links between physical and brain health, but they do not show that hemoglobin levels cause dementia or predict an individual’s outcome.
The research team examined adults aged 40 and older who received national health screenings in 2004–2005. Participants were grouped into five categories based on hemoglobin, a protein in red blood cells that carries oxygen. The researchers then used national health insurance records to identify new dementia diagnoses through the end of 2019, providing up to 15 years of follow-up.
Compared with the group the researchers identified as having the lowest dementia rate, people in the lowest fifth of hemoglobin levels had a 16% higher risk of all-cause dementia. People in the highest fifth had a 7% higher risk. For Alzheimer’s disease, the reported increase was concentrated in the lowest fifth, at 14%. For vascular dementia, the lowest fifth had a 19% higher risk and the highest fifth an 18% higher risk; across the five groups, that relationship did not follow a simple pattern.
The association was reported as clearer and more consistent in women than in men. The study describes statistical associations in this particular cohort, not a diagnostic test: the supplied report does not establish that hemoglobin measurements can determine whether an individual will develop dementia.
What Routine Blood Counts Could Reveal
Hemoglobin is already measured in many routine blood tests, making it an accessible measure for further research. Unlike specialist brain scans or emerging biomarkers, a hemoglobin result may already be available in a person’s medical record. Researchers said studying such measures could help clarify how whole-body health relates to brain health over time.
That potential should not be confused with a proven screening tool. The study did not test whether adding hemoglobin to clinical assessments improves dementia prediction, nor whether treating an abnormal result changes dementia risk. Its value at this stage is as a research clue that may help guide further investigation, not as a reason for people to alter treatment or seek a dementia diagnosis based on a blood count alone.
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How the Korean Cohort Was Tracked
The analysis drew on a large group who had health checks within South Korea’s national screening system in 2004–2005. Researchers categorized their hemoglobin measurements into five groups, then linked the screening data to national health insurance records for dementia diagnoses until the end of 2019. The long follow-up allowed the team to examine diagnoses recorded many years after the original measurements.
Hemoglobin levels can be affected by different health conditions and circumstances. Low levels are commonly associated with anemia; unusually high levels may be related to smoking, dehydration, lung or heart disease, or other medical conditions, according to the report. The study’s authors cautioned that these possibilities make it difficult to interpret the observed association as a direct effect of hemoglobin itself.
“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
routine blood test for health screening
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Limits of the Dementia Association
Because this was an observational study, it can identify a relationship but cannot establish that low or high hemoglobin caused later dementia. Other health factors could influence both hemoglobin and dementia risk. Researchers also noted that early, undiagnosed dementia processes might affect nutrition, frailty, weight loss, or anemia, potentially contributing to the pattern they observed.
The findings come from a South Korean cohort, and the report says the association was more consistent among women. It remains unclear whether the results apply to people with different backgrounds and health profiles, how useful hemoglobin would be in predicting risk for any one person, or whether acting on an abnormal level would change dementia outcomes. No treatment or prevention benefit was tested.
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Research Needed Before Clinical Use
Further studies will need to test whether the association appears in populations with a wider range of backgrounds and to examine why patterns differed by dementia type and sex. Researchers would also need to establish whether hemoglobin adds useful information to existing risk assessments and whether any clinical response affects later outcomes. The report does not specify a date for follow-up results or a planned next study.
For now, the researchers say people should not try to raise or lower hemoglobin to prevent dementia. Anyone with an abnormal blood-test result should discuss it with a doctor, since it may reflect an underlying health issue. The study’s findings are not medical advice and do not change how an individual should manage a blood-test result.
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Key Questions
Does low hemoglobin cause dementia?
The study does not establish that. It found an association between hemoglobin categories and later dementia diagnoses, but its observational design cannot show that hemoglobin caused the diagnoses.
What did the study find about high hemoglobin?
People in the highest fifth had a 7% higher risk of all-cause dementia than the comparison group identified as having the lowest dementia rate. For vascular dementia, the highest fifth had an 18% higher risk. These are cohort findings, not an individual prediction.
Should I take iron or change my hemoglobin level to prevent dementia?
No prevention benefit was established, and lead researcher Dr Hyun Soo Kim said the findings should not be treated as advice to take iron or raise or lower hemoglobin. Discuss an abnormal result with a doctor.
How long were participants followed?
The 316,542 adults had health screenings in 2004–2005, and researchers tracked new dementia diagnoses through the end of 2019—up to 15 years later.
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