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 [F] Diseases Research  / PubMed Research Articles  /
Serum Sodium and Cognition in Older Community-Dwelling Men.




Clinical journal of the American Society of Nephrology : CJASN Feb ; ()


Nowak KL1; Yaffe K2; Orwoll ES3; Ix JH4; You Z5; Barrett-Connor E6; Hoffman AR7; Chonchol M8;

Author Information
  • 1Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Kristen.Nowak@ucdenver.edu.
  • 2Departments of Psychiatry, Neurology, and Epidemiology, University of California San Francisco, San Francisco, California.
  • 3Bone and Mineral Unit, Oregon Health and Science University, Portland, Oregon.
  • 4Divisions of Nephrology and Preventative Medicine, University of California San Diego, San Diego, California.
  • 5Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
  • 6Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California; and.
  • 7Division of Endocrinology, Gerontology and Metabolism, Stanford University, Stanford, California.
  • 8Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.


BACKGROUND AND OBJECTIVES: Mild hyponatremia is a common finding in older adults; however, the association of lower serum sodium with cognition in older adults is currently unknown. We determined whether lower normal serum sodium is associated with cognitive impairment and risk of cognitive decline in community-dwelling older men.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Five thousand four hundred thirty-five community-dwelling men aged ≥65 years who participated in Osteoporotic Fractures in Men, a cohort study with a median follow-up for cognitive function of 4.6 years, were included in this analysis. Multivariable logistic regression was used to examine the association between baseline fasting serum sodium levels and the odds of prevalent cognitive impairment (cross-sectional analysis; modified Mini-Mental Status [3MS] score <1.5 SD [<84] below or Trail Making Test Part B time >1.5 SD above the mean [>223 seconds]) and cognitive decline (prospective analysis [n=3611]; decrease in follow-up 3MS score or increase in Trails B time >1.5 SD of the mean score/time change [>9 or >67 seconds]).

RESULTS: Participants were aged 74±6 years with a fasting mean serum sodium level of 141±3 mmol/L. Fifteen percent (n=274), 12% (n=225), and 13% (n=242) had prevalent cognitive impairment in tertiles 1, 2, and 3, respectively. After adjustment, lower serum sodium was associated with prevalent cognitive impairment (tertile 1 [126-140 mmol/L] versus tertile 2 [141-142 mmol/L], odds ratio [OR], 1.30; 95% confidence interval [95% CI], 1.06 to 1.61). Fourteen percent (n=159), 10% (n=125), and 13% (n=159) had cognitive decline in tertiles 1, 2, and 3, respectively. Lower serum sodium was also associated with cognitive decline (tertile 1 versus tertile 2, OR, 1.37; 95% CI, 1.06 to 1.77). Tertile 3 (143-153 mmol/L) was additionally associated with cognitive decline. Results were similar in sensitivity analyses according to clinical cut-offs and by quartiles.

CONCLUSIONS: In community-dwelling older men, serum sodium between 126-140, and 126-140 or 143-153 mmol/L, are independently associated with prevalent cognitive impairment and cognitive decline, respectively.

Copyright © 2018 by the American Society of Nephrology.




Publication Type: Journal Article

This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.

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