期刊
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
卷 13, 期 3, 页码 366-374出版社
AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.07400717
关键词
Aging; cognitive; electrolytes; Cross-Sectional Studies; Trail Making Test; Cognitive Dysfunction; Sodium; hyponatremia; Fasting; Prospective Studies; Follow-Up Studies; Logistic Models; Independent Living; Osteoporotic Fractures; Prevalence; Cognition
资金
- National Institutes of Health (NIH)
- National Institute on Aging
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- National Center for Advancing Translational Sciences
- NIH Roadmap for Medical Research [U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01AR066160, UL1 TR000128]
- American Diabetes Association [1-04-JF-46]
- National Institute of Diabetes and Digestive and Kidney Diseases [K01 DK103678]
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 746 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.
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