Cognitive and Peripheral Nerve Function Impairment in Iron Deficiency Anemia: Association with Serum Ferritin Levels in Adults

Abstract

Background: Iron deficiency anemia (IDA) is a global health concern with potential cognitive and neurological consequences. Iron is essential for neuronal myelination, neurotransmitter synthesis, and oxygen transport to the brain. This study investigates the relationship between iron deficiency and neurocognitive function in adults.Aim: To evaluate the correlation between serum ferritin levels and both cognitive function (measured by Montreal Cognitive Assessment [MoCA]) and peripheral nerve function (measured by Nerve Conduction Velocity [NCV]) in adults with iron deficiency anemia.Methods: This cross-sectional study included 134 participants (67 newly diagnosed untreated IDA cases and 67 healthy controls) aged 20-40 years recruited from a rural hospital in eastern Uttar Pradesh, India. Participants underwent complete blood count, serum ferritin measurement, MoCA testing for cognitive assessment, and NCV studies for peripheral nerve function evaluation. Statistical analysis included independent t-tests for group comparisons and Pearson's correlation coefficient to assess relationships between serum ferritin and neurocognitive parameters.Results: IDA participants showed significantly lower hemoglobin (9.2±2.1 vs. 12.9±0.9 g/dL, p<0.0001) and serum ferritin levels (8.87±2.34 vs. 24.21±4.97 ng/mL, p<0.0001) compared to controls. Significant impairments were observed in both motor and sensory nerve conduction parameters in IDA cases, with decreased MNCV (29.2±12.7 vs. 55.93±1.4 m/s, p<0.0001) and SNCV (36.05±13.9 vs. 24.29±4.9 m/s, p<0.0001). Though correlations between serum ferritin and neurocognitive measures did not reach statistical significance, positive trends were observed.Conclusion: While no statistically significant correlation was established between serum ferritin levels and neurocognitive function, the significant differences in MoCA scores and NCV parameters between IDA cases and controls suggest that iron deficiency may adversely affect both cognitive and peripheral nerve function. Early screening and management of IDA are recommended to potentially prevent neurological complications.