Association of hemoglobin-to-red blood cell distribution width ratio and cognition: a cross-sectional study

Purpose This study aimed to investigate the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and cognitive function. Methods Data, including cognition assessment, general characteristics, lifestyle attributes, disease-related factors, and blood indicators, were extracted from older people from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 database. Statistical analysis included the Mann-Whitney U-test, chi-square test, spearman correlation, and multiple linear regression. Results A total of 2452 participants were included, with 631(25.7%) identified as having low-level cognition. HRR was significantly lower in the lower cognition group (P<0.001) and positively associated with cognition score (P<0.001). Multiple linear logistic regression analysis indicated that HRR remained associated with cognition even after adjusting for general characteristics, lifestyle attributes, disease-related factors, and blood indicators (P=0.046). Conclusion Lower HRR is an independent risk factor for low cognitive performance in older adults. However, further investigation is needed to elucidate the precise mechanism underlying the impact of HRR on cognitive function.