Serum sodium, cognition and incident dementia in the general population
Author:
van der Burgh Anna C1232,
Pelouto Anissa12,
Mooldijk Sanne S32,
Zandbergen Adrienne A M12,
Ikram M Arfan32,
Chaker Layal1232,
Hoorn Ewout J12
Affiliation:
1. Department of Internal Medicine , Erasmus Medical Center, , Rotterdam , The Netherlands
2. University Medical Center Rotterdam , Erasmus Medical Center, , Rotterdam , The Netherlands
3. Department of Epidemiology , Erasmus Medical Center, , Rotterdam , The Netherlands
Abstract
Abstract
Background
Low serum sodium may be associated with cognitive impairment and dementia in the general population, but the data remain inconclusive. Therefore, we aimed to determine the association of low serum sodium with cognitive function and incident dementia in the general population.
Methods
Participants from a prospective population-based cohort were eligible if data on serum sodium (collected between 1997 and 2008), dementia prevalence and dementia incidence were available (follow-up until 2018). Global cognitive function was assessed with the Mini-Mental State Examination (MMSE) and the general cognitive factor (G-factor, derived from principal component analysis of individual tests). Linear regression and Cox proportional-hazards models were used to assess associations of standardised continuous and categorised low serum sodium (mean − 1.96*SD: cut-off of 137 mmol/L) with overall cognitive function and incident dementia, respectively.
Results
In all, 8,028 participants free of dementia at baseline (mean age 63.6 years, 57% female, serum sodium 142 ± 2 mmol/L), including 217 participants with low serum sodium, were included. Cross-sectionally, continuous serum sodium and/or low serum sodium were not associated with the MMSE or G-factor. However, participants with low serum sodium performed worse on the Stroop and Purdue Pegboard tests. During a median follow-up of 10.7 years, 758 subjects developed dementia. Continuous serum sodium (hazard ratio (HR) 0.98, 95% confidence interval (CI) 0.92;1.05) and low serum sodium (HR 1.27, 95% CI 0.90;1.79) were not associated with a higher risk of incident dementia.
Conclusion
We identified no significant associations of low serum sodium with overall cognitive functioning and risk of dementia. However, low serum sodium—including levels above the clinical cut-off for hyponatremia—was associated with impairments in selected cognitive domains including attention and psychomotor function.
Funder
Erasmus Medical Center and Erasmus University
Health Research and Development
Research Institute for Diseases in the Elderly
Ministry of Education, Culture and Science
Ministry for Health, Welfare and Sports, the European Commission
Municipality of Rotterdam
Publisher
Oxford University Press (OUP)
Subject
Geriatrics and Gerontology,Aging,General Medicine
Cited by
1 articles.
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