Sickle cell anemia may be associated with cognitive dysfunction, and some of its complications might affect those with sickle cell trait (SCT), so a team of researchers, including Drs. Marguerite Ryan Irvin and Suzanne Judd from the University of Alabama at Birmingham School of Public Health, hypothesized that SCT is a risk factor for cognitive impairment.
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.
Among 7743 participants followed for a median of 7·1 years, 85 of 583 participants with SCT developed incident cognitive impairment compared to 902 of 7160 without SCT. In univariate analysis, the odds ratio (OR) of incident cognitive impairment was 1·18 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.
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.Friday Letter Submission, Publish on August 02