MedicalResearch.com Interview with:
Dr. Kristen L. Nowak PhD
Division of Renal Diseases and Hypertension
University of Colorado Anschutz Medical Campus
Aurora, CO 80045
MedicalResearch.com: What is the background for this study?
Response: Subtle impairments in cognition are common with aging, even in the absence of clinically apparent dementia. Mild hyponatremia is a common finding in older adults; however, the association of lower serum sodium with cognition in older adults is currently uncertain.
We hypothesized that lower normal serum sodium would be associated with prevalent cognitive impairment and the risk of cognitive decline over time in asymptomatic, community-dwelling older men.
MedicalResearch.com: What are the main findings?
Response: Serum sodium between 126 and 140 mmol/L (mild hyponatremia and lower normal serum sodium) is associated with both prevalent cognitive impairment and cognitive decline in community-dwelling older men.
MedicalResearch.com: What should readers take away from your report?
Response: Mild hyponatemria or lower normal serum sodium, which may go unnoticed in clinical practice, is unlikely to be truly asymptomatic as serum sodium between 126-140 mmol/L was associated with cognitive impairment and cognitive decline. This is consistent with recent evidence that mild hyponatremia is also associated with gait disturbances, risk of falls, and risk of bone fractures, as well as cardiovascular events and mortality.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This study was limited to men and future research should evaluate whether lower serum sodium is associated with cognitive impairment in older women. Prior studies in severe acute hyponatremia suggest women are at higher risk of neurologic consequences. Additional research is also needed to discern the mechanisms by which lower serum sodium is associated with cognitive impairment and decline and whether correction of lower serum sodium may influence cognition in older adults.
Disclosures: Kristine Yaffe 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. Eric Orwoll provides consultancy for Merck and receives research funding from Merck and Lily. Michel Chonchol provides consultancy for Vifor and receives research funding from Otsuka.
Kristen L. Nowak, Kristine Yaffe, Eric S. Orwoll, Joachim H. Ix, Zhiying You, Elizabeth Barrett-Connor, Andrew R. Hoffman, and Michel Chonchol
Serum Sodium and Cognition in Older Community-Dwelling Men CJASN CJN.07400717; published ahead of print February 8, 2018, doi:10.2215/CJN.07400717
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