article · BMC Neurology
Investigating dementia vulnerability in high-risk populations, this study evaluated blood biochemical profiles alongside education, physical measures, and cognitive status in a cohort from Makurdi, Nigeria. Cognitive impairment was widespread, occurring at higher rates among individuals living with type 2 diabetes. A distinct gender pattern emerged, with women, particularly those with lower educational attainment, experiencing the highest risk. Biochemical investigations identified renal function indicators as potential blood-based markers for cognitive performance. Specifically, elevated levels of uric acid and urea correlated with worse cognitive scores, indicating an active kidney-brain axis. The combined impact of diabetes, female sex, and illiteracy created a compounding risk for cognitive decline. These outcomes point toward potential diagnostic pathways and support interventions targeting metabolic health and educational disparities to reduce cognitive deterioration.
Sub-Saharan African populations face a high burden of dementia, intensified by metabolic conditions such as diabetes. Demonstrating that simple blood markers of kidney function correlate with mental decline, alongside social factors like literacy, helps clinicians identify vulnerable groups sooner. This knowledge supports the creation of focused screening and preventative health strategies in resource-constrained medical settings.
This early-stage research could inform the development of blood-based diagnostic panels or risk-scoring tools integrating renal markers, such as urea and uric acid, with metabolic and demographic data. Potential users include clinical laboratories and diagnostic developers focusing on dementia screening in diabetic populations. Because the findings derive from an observational cohort study, substantial clinical validation and biomarker standardisation are required before commercial or routine clinical use.
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BACKGROUND: Sub-Saharan Africans and Afro-Americans face 2-to-8 times higher risk of dementia compared to Caucasians, with Nigerian people being the highest population-at-risk. Adding to this challenge, their unique lipid profile increases their susceptibility to type 2 diabetes mellitus (DM-2), which further raises the risk of cognitive impairment (CI) by 1.5 times. Recently, we demonstrated a strong Diabetes/Dementia tandem in Nigerians, with increased cognitive vulnerability in illiterate, short-height, and diabetic Nigerian women in the eye of the storm. The combination of factors within this population makes it the optimal scenario to understand the relationship between CI and DM-2. METHODS: Here, we further studied the blood biochemical analysis of our Makurdi cohort and searched for correlations with standard anthropometric measures, educational level, cognitive status (as assessed with MMSE, 6-CIT) and DM-2. RESULTS: CI was prevalent across all groups, with higher incidence in DM-2 subjects and a marked sexual dimorphism. Thus, women exhibited a greater risk, especially those with low educational attainment. In the search for potential blood-based biomarkers for cognitive function, we identified those related to renal function. In particular, elevated uric acid and urea levels were associated with poorer cognitive performance, highlighting a potential kidney-brain axis connection. CONCLUSION: Renal function blood metabolites in this Nigerian cohort have been identified as possible kidney-brain axis biomarkers of CI. Moreover, illiteracy, female sex, and DM-2 pose them a compounded risk of developing CI. These findings advocate that targeted interventions addressing educational disparities and metabolic health could be proposed to mitigate cognitive decline in these vulnerable sub-groups. The integration of these factors provides a comprehensive understanding of CI incidence in Nigeria's population, offering new avenues for diagnosis, prevention, and treatment strategies. CLINICAL TRIAL NUMBER: Not applicable.
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DOI: 10.1186/s12883-025-04173-w
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