Association Between Micronutrients and Cognitive Performance Among Adolescents and Young Adults Living With Sickle...

Cognitive deficits are commonly reported in patients with sickle cell disease (SCD). Dietary micronutrient intake is a potential modifiable risk factor whose relationship with cognition in SCD patients remains poorly characterised. This study aimed to determine the association between dietary micronutrient intake and cognition among these cohorts.

Among 128 participants were 64 stable SCD patients (Group-1) and 64 non-SCD community controls (Group-2), aged 13-24 years. A comparative cross-sectional study was conducted. Recruitment occurred in the same community catchment area served by the KNUST University Hospital SCD clinic. A 24-h dietary recall and the digit span test (DST) were used for dietary intake and cognition assessment, respectively. Mann-Whitney U test was used for group comparison and Spearman correlation with multiple linear regression for the associations between micronutrients and cognitive score, adjusting for confounding variables. Multiple comparisons were corrected with Benjamini-Hochberg false discovery rate (FDR).

Females constituted 73.4% of the SCD and 68.8% of the control group. The respective mean ages of Group-1 and Group-2 were 19.7 (±1.5) and 20.1 (±1.6) years (p = 0.249). Group-1 had a lower mean haemoglobin (9.35g/dL) than Group-2 (12.37g/dL). There was no significant between-group difference observed in dietary micronutrient intake after FDR correction. The total digit span score was unexpectedly higher in Group-1 (median 15.5) than Group-2 (median 13.5; p = 0.006); genotype-stratified analysis revealed that this was driven by HbSS participants (β = +2.641 vs. HbAA; p = 0.001) and offset by HbSC participants (β = -2.983 vs. HbAA; p = 0.001). In the fully adjusted model, niacin showed a borderline positive association with total digit span (β = +0.791 per doubling of intake; 95% CI: -0.002 to +1.584; p = 0.053), which was robust to confounder adjustment. No association was statistically significant after FDR correction.

There was no dietary micronutrient independently associated with cognitive performance after adjustment for multiple comparisons. However, niacin and selenium exhibited biologically plausible trends that warrant further investigation.

The authors have confirmed clinical trial registration is not needed for this submission.