- Both types of iron deficiency matter: Absolute (low ferritin) and functional (low transferrin saturation despite normal ferritin) iron deficiency were each associated with higher dementia risk.
- Independent of many confounders: Associations persisted after adjustment for age, sex, education, cardiovascular disease, and comorbidity burden, and were robust in sensitivity analyses.
- Not solely driven by anemia: The association remained for absolute iron deficiency even among individuals without anemia, suggesting a mechanism beyond hemoglobin levels.
- Subgroup variation exists: Absolute iron deficiency showed stronger associations in younger-old adults (50–74 years), while functional deficiency was more prominent in older adults (≥75 years) and those with comorbidities.
- Observational design limits inference: Dementia ascertainment relied mainly on specialist care data, and residual confounding and selection bias cannot be excluded.
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