Excessive Dietary Salt Intake Exacerbates Cognitive Impairment Progression and Increases Dementia Risk in Older Adults

Liu, Weike; Xing, Shasha; Wei, Fang; Yao, Yanli; Zhang, Hua; Li, Yuechun; Liu, Zhendong

doi:10.1016/j.jamda.2022.10.001

Cited by 11 publications

(15 citation statements)

References 28 publications

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“…Further analysis is required to explore this aspect in more detail and gain a comprehensive understanding of the association. relationship between salt and dementia in an elderly population (Liu et al, 2023). Our study further clarifies the causal relationship between salt and dementia through MR studies.…”

Section: Numbersupporting

confidence: 69%

Association between adding salt in food and dementia in European descent: A mendelian randomization study

Zhou,

Chen,

Zhang

et al. 2024

Brain and Behavior

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BackgroundHigh salt intake has been proposed as a risk factor for dementia. However, causal relationship between salt intake and dementia remains uncertain.PurposeThe aim of this study was to employ a mendelian randomization (MR) design to investigate the causal impact of salt intake on the risk of dementia.MethodsGenome‐wide association study (GWAS) data of exposures and outcomes (any dementia, cognitive performance, different types of dementia, Alzheimer's disease [AD], and Parkinson's disease) were obtained from the IEU database. MR estimates were generated though inverse‐variance weighted model. MR‐Egger, weighted median, and MR‐Pleiotropy Residual Sum and Outlier (MR‐PRESSO) method also used in our study. Sensitivity analyses included Cochran's Q test, MR‐Egger intercept, MR‐PRESSO global test and outlier test, leave‐one‐out analysis, and funnel plot assessment.ResultsOur MR analysis provided evidence of a causal association between high salt added to food and dementia (odds ratio [OR] = 1.73, 95% confidence interval [CI]: 1.21–2.49, and p = .003), dementia in AD (OR = 2.10, 95% CI: 1.15–3.83, and p = .015), and undefined dementia (OR = 2.61, 95% CI: 1.26–5.39, and p = .009). Higher salt added was also associated with increased risk of AD (OR = 1.80, 95% CI: 1.12–2.87, and p = .014) and lower cognitive performance (β = −.133, 95% CI: −.229 to −.038, and p = .006).ConclusionThis study provides evidence suggesting that high salt intake is causally associated with an increased risk of developing dementia, including AD and undefined dementia, highlighting the potential importance of reducing salt consumption as a preventive measure.

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Section: Numbersupporting

confidence: 69%

Association between adding salt in food and dementia in European descent: A mendelian randomization study

Zhou,

Chen,

Zhang

et al. 2024

Brain and Behavior

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“…In a Chinese cohort study, excessive dietary salt aggravated cognitive impairment progression and increased dementia risk in older adults independently of known risk factors, including hypertension and apolipoprotein E genotype. 35 In a previous study, a salt-rich diet caused brain endothelial dysfunction, cerebral hypoperfusion, and hyperphosphorylation of tau, which subsequently led to cognitive dysfunction in mice. 36 These findings may suggest a causal relationship between dietary salt and Alzheimer’s disease.…”

Section: Discussionmentioning

confidence: 96%

Effect of Dietary Habits on Alzheimer’s Disease Progression

Ahn,

Jeong,

Park

et al. 2024

Yonsei Med J

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Purpose Research on the relationship between diet and dementia among Koreans are lacking. This study investigated the association between dietary habits and dementia progression over 3 years in patients with Alzheimer’s disease dementia (ADD). Materials and Methods This study included 705 patients with mild-to-moderate ADD. Dietary habits were assessed using the Mini Dietary Assessment Index, comprising 10 questions. Outcome measures included the Clinical Dementia Rating scale-Sum of Boxes (CDR-SB), Seoul-Instrumental Activities of Daily Living, Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI), and neuropsychological test battery (NTB) z-scores, which were evaluated annually over 3 years. Results In Q10 (eat all food evenly without being picky), the 3-year mean differences in CDR-SB (increases in scores represent worsening) compared to the “rarely” group were -1.86 [95% confidence interval (CI)=-3.64 – -0.09, p =0.039] for the “usually” group and -2.23 (95% CI=-4.40 – -0.06, p =0.044) for the “always” group. In Q7 (add salt or soy sauce to food when eating), the 3-year mean differences in CDR-SB compared to the “always” group were -2.47 (95% CI=-4.70 – -0.24, p =0.030) for the “usually” group and -3.16 (95% CI=-5.36 – -0.96, p =0.005) for the “rarely” group. The “rarely” and “usually” groups in Q7 showed significantly less decline in NTB z-score and CGA-NPI compared to the “always” group. Conclusion Eating a balanced diet and reducing salt intake were associated with a slower decline in dementia severity, cognition, and behavioral alterations in patients with ADD.

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“…The urine samples were collected in the spring or autumn to minimize sweating which may bias the results [ 16 ]. We used the spot urine with Tanaka equation to determine the changes of salt intake styles across the follow-up period [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

“…Depending on the salt intake estimation, participants were classified into low (≤ 6.00 g/day of salt intake), mild (6.01–9.00 g/day of salt intake), moderate (9.01–12.00 g/day of salt intake), and high (> 12.00 g/day of salt intake) groups depending on the Dietary Guidelines for Chinese Residents [ 17 , 20 ]. Characteristics of participants in different groups are presented as means ± standard deviation (SD) or medians with interquartile range for measurement data depending on the normality, and frequency with percentages for enumeration data.…”

Section: Methodsmentioning

confidence: 99%

Excessive salt intake accelerates the progression of cerebral small vessel disease in older adults

Liu

Zhang

Xing³

et al. 2023

BMC Geriatr

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Background It is unclear whether excessive salt intake accelerates the progression of cerebral small vessel disease (CSVD). The major objective of this study was to investigate the harmful effect of excessive salt intake on the progression of CSVD in older individuals. Methods Between May 2007 and November 2010, 423 community-dwelling individuals aged 60 years and older were recruited from the Shandong area, China. Salt intake was estimated using 24-hour urine collection for 7 consecutive days at baseline. Participants were classified into low, mild, moderate and high groups according to the salt intake estimation. CSVD including white matter hyperintensities (WMHs), lacunes, microbleeds and an enlarged perivascular space (EPVS) were determined using brain magnetic resonance imaging. Results During an average of five years of follow-up, the WMH volume and WMH-to-intracranial ratio were increased in the four groups. However, the increasing trends in the WMH volume and WMH-to-intracranial ratio were significantly faster in the higher salt intake groups compared with the lower salt intake groups (Padjusted < 0.001). The cumulative hazard ratios of new-incident WMHs (defined as those with Fazekas scale scores ≥ 2), new-incident lacunes, microbleeds or an EPVS, as well as composites of CSVD, were respectively 2.47, 2.50, 3.33, 2.70 and 2.89 for the mild group; 3.72, 3.74, 4.66, 4.01 and 4.49 for the moderate group; and 7.39, 5.82, 7.00, 6.40 and 6.61 for the high group, compared with the low group after adjustment for confounders (Padjusted < 0.001). The risk of new-incident WMHs, lacunes, microbleeds or an EPVS, and composites of CSVD was significantly increased with each 1-standard-deviation increment in salt intake (Padjusted < 0.001). Conclusion Our data indicates that excessive salt intake is an important and independent contributor to the progression of CVSD in older adults.

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Excessive Dietary Salt Intake Exacerbates Cognitive Impairment Progression and Increases Dementia Risk in Older Adults

Cited by 11 publications

References 28 publications

Association between adding salt in food and dementia in European descent: A mendelian randomization study

Association between adding salt in food and dementia in European descent: A mendelian randomization study

Effect of Dietary Habits on Alzheimer’s Disease Progression

Excessive salt intake accelerates the progression of cerebral small vessel disease in older adults

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