Developing Topics.

Abstract

Semantic verbal fluency (SMF) has been identified as an early marker of mild cognitive impairment (MCI). Anemia and some micronutrient deficiencies (MD) have been considered as risk factor for MCI. In Mexico, it has been poorly studied the nutritional drivers associated to MCI. Anemia and MD are frequent in vulnerable Mexican population but controversial exist around the criteria to define such entities in older adults (OA).The aim is to analyse the association between hemoglobin concentration, iron and B12 status, as well as the causes of anemia with SVF in older Mexican adults. 802 OA from 4 urban localities in Campeche and Yucatan -most of them considered themselves as Mayan indigenous- donated a capillary and venous blood sample. Hb (g/dL) was measured in capillary blood using Hemocue. Ferritin, vitamin B12, transferrin receptors (stfr), and other biomarkers were analysed in serum. The causes of anemia were classified as: Iron deficiency (ID), B12 deficiency (B12D), inflammatory, renal, multiple and unexplained. We explored the quartiles (Q) of Hb -sex adjusted-, s-ferritin, and stfr with SVF. Anemia, causes of anemia and MD were modelled separately using multiple linear regression models adjusted by confounders. Anemia, ID and B12D affected to 35.3%, 5% and 10% of OA, respectively. The mean of SVF was 13-5±6.5 words. The Q1 [coef = -1.4, p = 0.025], Q2 [coef = -1.46, p = 0.016] and Q3 [coef = -1.13, p = 0.05] of Hb were negatively associated with SVF in comparison with Q4. No association was observed between the quartiles of s-ferritin, stfr, ID or B12D with SVF. Total anemia (-0.9, p = 0.047), and particularly B12D anemia (-3.5, p = 0.018), were associated to lower SVF vs non-anemics. Higher Hb values (≥13.3 g/dL for women and ≥14.7 g/dL for men) above the cut-off of anemia were positively associated with SVF independent of MD. This finding suggests that normal Hb values in those ranges of Hb might hide a declining in brain function secondary to an inadequate delivery of cerebral oxygen. Those with B12D anemia had the worse SVF performance. It is necessary to identify the main drivers for the optimal Hb range where the OA is functional independent to target early interventions.