Inflammation marker CRP/albumin ratio linked to mild cognitive impairment in older adults

The research team, led by Handan Duman, Mehmet Kivrak and Omer Lutfi Gundogdu, recruited 300 participants aged 65 and older who were evaluated at a Healthy Aging Center and a Neurology Outpatient Clinic. Cognitive status was assessed with the Montreal Cognitive Assessment, or MoCA, a widely used screening tool, while blood samples yielded measurements of C-reactive protein, albumin, glucose, hemoglobin and a complete blood count. The CAR was calculated as CRP divided by albumin, multiplied by 100.

To keep the analysis clean, the investigators excluded anyone with conditions that could inflate inflammatory markers for reasons unrelated to cognition. People with acute infection, systemic inflammatory disease, malignancy, immune deficiency, recent trauma, end-stage organ failure, or major psychiatric or neurological disorders were not eligible.

The results were striking. Of the 300 participants, 204, or 68 percent, met criteria for mild cognitive impairment. In this group, median CAR values reached 34.9, compared with 19.5 in participants without impairment, a difference that was highly significant. Albumin and glucose levels, by contrast, were lower in the impaired group.

Correlation analysis reinforced the pattern. Among all the laboratory parameters measured, CAR showed the strongest relationship with MoCA score, with a Spearman correlation coefficient of minus 0.40, a moderate inverse association that was statistically significant. Glucose and albumin also tracked with cognitive status, both showing inverse associations in the regression models.

To test whether CAR was merely a passenger alongside other variables, the researchers ran univariable and multivariable logistic regression analyses. In the final multivariable model, CAR remained independently associated with mild cognitive impairment, with an odds ratio of 1.035 per unit increase and a 95 percent confidence interval of 1.019 to 1.053. Albumin and glucose each showed inverse associations, meaning lower levels were linked to higher odds of impairment. The model’s explanatory power, however, was modest, with a Nagelkerke R-squared of 0.307, indicating that these blood markers together accounted for only part of the variation in cognitive status.

The authors are careful about interpretation. Because the study is cross-sectional, capturing a single moment in time, it cannot establish whether inflammation drives cognitive decline or whether some other process produces both. The modest explanatory power of the model further cautions against treating CAR as a standalone diagnostic marker. The conclusion states plainly that CAR should not be interpreted as causal or as a diagnostic tool on its own, and that longitudinal and multicenter studies are needed to evaluate whether inflammatory profiles including CAR are related to cognitive trajectories over time.

The single-center design and the exclusion of people with acute illness strengthen the internal logic of the findings while limiting how broadly they can be generalized.

Subject of Research: Association between the CRP/albumin inflammatory marker and mild cognitive impairment in older adults

Article Title: Evaluation of the relationship between mild cognitive impairment and CRP/Albumin ratio in the geriatric population

Article References: Duman, H., Kivrak, M., & Gundogdu, O. L. (2026). Evaluation of the relationship between mild cognitive impairment and CRP/Albumin ratio in the geriatric population. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08373-y

Image Credits: AI Generated

DOI: 10.1186/s12877-026-08373-y

Keywords: mild cognitive impairment, CRP/albumin ratio, systemic inflammation, older adults, MoCA, cross-sectional study, logistic regression, BMC Geriatrics, cognitive decline, inflammatory markers, geriatrics, albumin