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A long-term study of 316,542 adults in South Korea found that people with the lowest hemoglobin levels had a higher rate of later dementia diagnoses; the highest levels were also associated with increased risk in some analyses. The observational findings do not show that hemoglobin causes dementia or that changing it would prevent the disease.
A study tracking 316,542 South Korean adults found that hemoglobin levels recorded during routine health checks were associated with dementia diagnoses over the following years, suggesting a familiar blood-test measure could offer clues about long-term brain health. The researchers stressed that the observational findings do not show that hemoglobin causes dementia or that changing its level would prevent the condition.
The participants were aged 40 and older and had national health screenings in 2004–2005. Researchers grouped them into five categories based on hemoglobin levels, then used national health insurance records to identify new dementia diagnoses through the end of 2019, a follow-up period of up to 15 years.
Compared with the group that had the lowest dementia rate, people in the lowest fifth of hemoglobin levels had a 16% higher risk of all-cause dementia. Those in the highest fifth had a 7% higher risk. These figures describe associations between groups in this study, not an individual’s personal prediction of developing dementia.
The pattern varied by diagnosis. For Alzheimer’s disease, the increased risk was chiefly observed among participants in the lowest hemoglobin group, whose risk was 14% higher than the reference group. For vascular dementia, the lowest group had a 19% higher risk and the highest group an 18% higher risk. The relationship for vascular dementia did not follow a simple step-by-step pattern across all five groups. Researchers also said the association was clearer and more consistent among women than men.
Why Routine Blood Results Matter
Hemoglobin is a protein in red blood cells that carries oxygen through the body. It is measured in common blood tests, making it widely available in routine medical records. The researchers say that makes it a potentially useful clue for studying how general physical health and brain health may be linked, rather than a new diagnostic test for dementia.
Lead researcher Dr Hyun Soo Kim, an assistant professor at Dong-A University College of Medicine, said the findings suggest abnormal hemoglobin levels may be a visible marker of broader physical vulnerability relevant to brain health. The study does not establish that the test can predict which individual will develop dementia, and it offers no evidence that correcting a result will lower risk.
That distinction matters for patients: an unusual result can have many possible explanations and should be interpreted in light of a person’s overall health. The report does not justify taking iron or trying to raise or lower hemoglobin as a dementia-prevention measure.
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How the Study Tracked Dementia
The research was presented at the 39th ECNP Congress in Munich and published in the Journal of Alzheimer’s Disease. Its large cohort and long follow-up allowed the team to compare screening results with later diagnoses recorded in national health insurance data.
Hemoglobin levels can be affected by different conditions and circumstances. Low levels are commonly associated with anemia; unusually high levels may reflect factors such as smoking, dehydration, lung or heart disease, or other medical conditions. Those possibilities mean the blood-test result is not specific to dementia.
External commentator Dr Lindsey Sinclair of the University of Southampton said the study adds to evidence that physical and brain health are interconnected. She also said further work is needed to determine whether the association applies to people from a wider range of backgrounds and what, if anything, could reduce dementia risk among people with very low or high hemoglobin.
“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
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What the Association Cannot Establish
Because the study was observational, it can identify a relationship but cannot establish that low or high hemoglobin caused dementia. Other health factors could contribute to both an abnormal blood result and later dementia diagnoses. The researchers also noted that early, undiagnosed dementia processes might affect nutrition, frailty, weight loss, or anemia, potentially helping explain the association.
The findings come from a cohort of adults in South Korea, and the report does not establish whether the same patterns would appear in other populations. It also does not explain why associations differed by dementia type or were more consistent among women. The reported risk differences are group comparisons, not a clinical risk calculator or a forecast for any one patient.
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Research Needed Beyond This Cohort
Further studies will be needed to test whether the association appears in populations with different backgrounds and to investigate how hemoglobin relates to other health conditions and dementia pathways. Researchers would also need evidence beyond an observational link to determine whether any change in clinical care affects dementia outcomes.
For now, Kim advised people to discuss an abnormal hemoglobin result with a doctor because it may point to an underlying health issue that deserves attention. The study provides no basis for self-treatment with supplements or for attempts to alter hemoglobin specifically to prevent dementia.
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Key Questions
Does a routine blood test predict whether I will develop dementia?
No. The study found group-level associations between hemoglobin and later diagnoses; it did not establish a reliable prediction for an individual.
Did low hemoglobin cause dementia in the study?
The study cannot show cause and effect. The researchers said other health factors, including possible early effects of undiagnosed dementia, could help explain the association.
Were high hemoglobin levels also associated with dementia?
Participants in the highest fifth had a 7% higher risk of all-cause dementia than the reference group. For vascular dementia, the highest fifth had an 18% higher risk; the pattern was not consistent across all five groups.
Should I take iron or change my hemoglobin level to prevent dementia?
No prevention benefit was established. 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.
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