TY - JOUR
T1 - Serum sodium and cognition in older community-dwelling men
AU - Nowak, Kristen L.
AU - Yaffe, Kristine
AU - Orwoll, Eric S.
AU - Ix, Joachim H.
AU - You, Zhiying
AU - Barrett-Connor, Elizabeth
AU - Hoffman, Andrew R.
AU - Chonchol, Michel
N1 - Funding Information:
TheOsteoporoticFracturesinMenStudyissupportedbyNational Institutes of Health (NIH) funding. The following institutes provide support: the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center forAdvancingTranslationalSciences, andtheNIHRoadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. Additional support was provided by the American Diabetes Association (1-04-JF-46). K.L.N. is supported by the National Institute of Diabetes and Digestive and Kidney Diseases, K01 DK103678.
Funding Information:
K.Y. serves on the data safety monitoring board for Takeda Pharmaceuticals Inc. and a National Institutes of Health–sponsored study. She provides consultancy for Novartis and Pfizer and is on the Beeson Scientific Advisory Board. E.S.O. provides consultancy for Merck and receives research funding from Merck and Lily. M.C. provides consultancy for Vifor and receives research funding from Otsuka.
Funding Information:
The Osteoporotic Fractures in MenStudyis supported by National Institutes of Health (NIH) funding. The following institutes provide support: the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center for Advancing Translational Sciences, and the NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. Additional support was provided by the American Diabetes Association (1-04-JF-46). K.L.N. is supported by the National Institute of Diabetes and Digestive and Kidney Diseases, K01 DK103678. The funding agencieshad no direct role in the conduct of the study; the collection, management, analyses, and interpretation of the data; or preparation or approval of the manuscript. Because M.C. is a Deputy Editor of the Clinical Journal of the American Society of Nephrology, he was not involved in the peer review process for this manuscript. Another editor oversaw the peer review and decision-making process for this manuscript.
Publisher Copyright:
© 2018 by the American Society of Nephrology.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/3/7
Y1 - 2018/3/7
N2 - 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 7466 years with a fasting mean serum sodium level of 14163 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.
AB - 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 7466 years with a fasting mean serum sodium level of 14163 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.
KW - Aging
KW - Cognition
KW - Cognitive
KW - Cognitive Dysfunction
KW - Cross-Sectional Studies
KW - Electrolytes
KW - Fasting
KW - Follow-Up Studies
KW - Hyponatremia
KW - Independent Living
KW - Logistic Models
KW - Osteoporotic Fractures
KW - Prevalence
KW - Prospective Studies
KW - Prospective Studies
KW - Sodium
KW - Trail Making Test
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U2 - 10.2215/CJN.07400717
DO - 10.2215/CJN.07400717
M3 - Article
C2 - 29439092
AN - SCOPUS:85043332788
VL - 13
SP - 366
EP - 374
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
SN - 1555-9041
IS - 3
ER -