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ORIGINAL RESEARCH article

Front. Med.

Sec. Geriatric Medicine

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1625542

This article is part of the Research TopicChallenges and Innovations in Healthcare Management and Long-Term Care for an Aging SocietyView all 21 articles

Hemoglobin-to-Red Blood Cell Distribution Width Ratio: A New Insight into Cognitive Protection for Obese Individuals

Provisionally accepted
Ruikai  XuRuikai XuZhonghua  LiuZhonghua Liu*Zelin  WuZelin Wu
  • Zhongshan People's Hospital (ZSPH), Zhongshan, China

The final, formatted version of the article will be published soon.

Background and Objective: Aging and obesity are recognized as risk factors for cognitive decline. Hemoglobin (Hb) reflects oxygen supply capacity, while red blood cell distribution width (RDW) reflects levels of inflammation and oxidative stress. The hemoglobin-to-red blood cell distribution width ratio (HRR), by integrating the core physiological functions of Hb and RDW, can more comprehensively reflect the common mechanisms affecting aging, obesity, and cognitive function. The objective of this research was to explore the link between the HRR and cognitive performance among the obese population. Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) and employed multiple regression analysis, smooth curve fitting, and subgroup analysis to investigate the relationship between HRR and cognitive function. Results: 1,055 obese individuals aged ≥ 60 years participated in the study. After adjusting for covariates, HRR was significantly positively correlated with DSST scores (β = 14.45; 95% CI, 7.55-21.35) and total cognitive Z-scores (β = 1.53; 95% CI, 0.40-2.67). HRR was significantly negatively correlated with low cognitive function as assessed by DSST (OR = 0.04; 95% CI, 0.01-0.23). Compared to individuals with lower education levels, those with higher educational backgrounds showed a more pronounced positive correlation between HRR and DSST scores. Conclusions: Maintaining a higher HRR may be an important strategy for protecting cognitive function in obese individuals aged ≥ 60 years.

Keywords: Hemoglobin, red blood cell distribution width ratio, Cognitive Function, obese, NHANES

Received: 09 May 2025; Accepted: 25 Aug 2025.

Copyright: © 2025 Xu, Liu and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Zhonghua Liu, Zhongshan People's Hospital (ZSPH), Zhongshan, China

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