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Decreased hemoglobin levels, cerebral small-vessel disease, and cortical atrophy: among cognitively normal elderly women and men

  • Sang Eon Park (a1) (a2) (a3), Hojeong Kim (a1) (a2) (a3), Jeongmin Lee (a1) (a2) (a3), Na Kyung Lee (a1) (a2) (a3), Jung Won Hwang (a1) (a2) (a3), Jin-ju Yang (a4), Byoung Seok Ye (a5), Hanna Cho (a6), Hee Jin Kim (a1) (a2), Yeo Jin Kim (a1) (a2), Na-Yeon Jung (a1) (a2), Tae Ok Son (a1) (a2), Eun Bin Cho (a1) (a2), Hyemin Jang (a1) (a2), Eun Young Jang (a1) (a2), Chang Hyung Hong (a7), Jong-Min Lee (a4), Mira Kang (a8), Hee-Young Shin (a8), Duk L. Na (a1) (a2) (a3) and Sang Won Seo (a1) (a2) (a9)...



Decreased hemoglobin levels increase the risk of developing dementia among the elderly. However, the underlying mechanisms that link decreased hemoglobin levels to incident dementia still remain unclear, possibly due to the fact that few studies have reported on the relationship between low hemoglobin levels and neuroimaging markers. We, therefore, investigated the relationships between decreased hemoglobin levels, cerebral small-vessel disease (CSVD), and cortical atrophy in cognitively healthy women and men.


Cognitively normal women (n = 1,022) and men (n = 1,018) who underwent medical check-ups and magnetic resonance imaging (MRI) were enrolled at a health promotion center. We measured hemoglobin levels, white matter hyperintensities (WMH) scales, lacunes, and microbleeds. Cortical thickness was automatically measured using surface based methods. Multivariate regression analyses were performed after controlling for possible confounders.


Decreased hemoglobin levels were not associated with the presence of WMH, lacunes, or microbleeds in women and men. Among women, decreased hemoglobin levels were associated with decreased cortical thickness in the frontal (Estimates, 95% confidence interval, −0.007, (−0.013, −0.001)), temporal (−0.010, (−0.018, −0.002)), parietal (−0.009, (−0.015, −0.003)), and occipital regions (−0.011, (−0.019, −0.003)). Among men, however, no associations were observed between hemoglobin levels and cortical thickness.


Our findings suggested that decreased hemoglobin levels affected cortical atrophy, but not increased CSVD, among women, although the association is modest. Given the paucity of modifiable risk factors for age-related cognitive decline, our results have important public health implications.


Corresponding author

Correspondence should be addressed to: Sang Won Seo, Professor, Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, South Korea. Phone: +82-2-3410-1233/-3599; Fax: +82-2-3410-0052. Email:


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Decreased hemoglobin levels, cerebral small-vessel disease, and cortical atrophy: among cognitively normal elderly women and men

  • Sang Eon Park (a1) (a2) (a3), Hojeong Kim (a1) (a2) (a3), Jeongmin Lee (a1) (a2) (a3), Na Kyung Lee (a1) (a2) (a3), Jung Won Hwang (a1) (a2) (a3), Jin-ju Yang (a4), Byoung Seok Ye (a5), Hanna Cho (a6), Hee Jin Kim (a1) (a2), Yeo Jin Kim (a1) (a2), Na-Yeon Jung (a1) (a2), Tae Ok Son (a1) (a2), Eun Bin Cho (a1) (a2), Hyemin Jang (a1) (a2), Eun Young Jang (a1) (a2), Chang Hyung Hong (a7), Jong-Min Lee (a4), Mira Kang (a8), Hee-Young Shin (a8), Duk L. Na (a1) (a2) (a3) and Sang Won Seo (a1) (a2) (a9)...


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