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Sickle cell trait and risk of cognitive impairment in African-Americans: The REGARDS cohort

  1. Author:
    Cahill, Christina R
    Leach, Justin M
    McClure, Leslie A
    Irvin, Marguerite Ryan
    Zakai, Neil A
    Naik, Rakhi
    Unverzagt, Frederick
    Wadley, Virginia G
    Hyacinth, Hyacinth I
    Manly, Jennifer
    Judd, Suzanne E
    Winkler,Cheryl
    Cushman, Mary

  2. Author Address

    Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America., Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States of America., Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States of America., Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America., Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America., Department of Medicine, Johns Hopkins University, Baltimore, MD, United States of America., Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States of America., Department of Medicine, Division of Gerontology Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, United States of America., Aflac Cancer and Blood Disorder Center of Children 39;s Healthcare of Atlanta, Department of Pediatrics, Emory University, Atlanta, GA, United States of America., The Taub Institute for Research in Alzheimer 39;s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, United States of America., Molecular Genetics Epidemiology Section, Frederick National Laboratory for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, United States of America.,
    1. Year: 2019
    2. Date: May-Jun
    3. Epub Date: 2019 05 24
  2. Journal: EClinicalMedicine
    1. 11
    2. Pages: 27-33
  4. Type of Article: Article
  1. Abstract:

    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: 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: 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 p?>?0·11). INTERPRETATION: 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: National Institutes of Health, American Society of Hematology.

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External Sources

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  2. DOI: 10.1016/j.eclinm.2019.05.003
  3. PMID: 31312804
  4. PMCID: PMC6610762
  5. PII : S2589-5370(19)30077-X

Library Notes

  1. Fiscal Year: FY2018-2019
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