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Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Hypernatremia | Research article

Serum sodium in relation to various domains of cognitive function in the elderly US population

Authors: Sohyae Lee, Jin-young Min, Beom Kim, Sang-Won Ha, Jeohng Ho Han, Kyoung-bok Min

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

Recent evidence suggests that sodium imbalances may be associated with cognitive impairment; however, the association between specific domains of cognition remains unclear. This study examines the association between serum sodium levels and immediate and delayed verbal memory as measured by the CERAD Word Learning Test (CERAD WLT), executive function as measured by the Animal Fluency test (AFT), and sustained attention, working memory, and processing speed as measured by the Digit Symbol Substitution test (DSST) in the elderly population of the US aged 60 and older who participated in the 2011–2014 National Health and Nutrition Examination Surveys (n = 2,541).

Methods

Cognitive function tests were performed by trained interviewers and sodium levels were measured using indirect ion selective electrode methodology.

Results

After adjusting for all covariates, quintiles of CERAD WLT scores showed significant positive associations with log-transformed sodium levels (Immediate recall (IR) β = 4.25 (SE = 1.83, p-value 0.027); Delayed recall (DR) β = 6.54 (SE = 1.82, p-value 0.001)). Compared to normal sodium levels, hyponatremia was significantly associated with lower CERAD WLT-IR (β = -0.34, SE = 0.15, p-value 0.035) and CERAD WLT-DR scores (β -0.48, SE = 0.10, p-value < 0.001) and showed borderline significance with AFT scores (β = = -0.38, SE = 0.19, p-value 0.052). Hypernatremia did not show any significant relationships with cognitive test scores, compared to normal sodium levels.

Conclusions

Our cross-sectional study showed that lower sodium levels were associated with cognitive change, especially regarding memory and executive function.
Literature
1.
go back to reference Shrimanker I, Bhattarai S. Electrolytes. StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2020, StatPearls Publishing LLC.; 2020. Shrimanker I, Bhattarai S. Electrolytes. StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2020, StatPearls Publishing LLC.; 2020.
2.
go back to reference Terry J. The major electrolytes: sodium, potassium, and chloride. Journal of intravenous nursing: the official publication of the Intravenous Nurses Society. 1994;17(5):240–7. Terry J. The major electrolytes: sodium, potassium, and chloride. Journal of intravenous nursing: the official publication of the Intravenous Nurses Society. 1994;17(5):240–7.
3.
go back to reference Sahay M, Sahay R. Hyponatremia. A practical approach. Indian J Endocrinol Metab. 2014;18(6):760–71.CrossRef Sahay M, Sahay R. Hyponatremia. A practical approach. Indian J Endocrinol Metab. 2014;18(6):760–71.CrossRef
4.
go back to reference Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med. 2006;119(7 Suppl 1):30-5. Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med. 2006;119(7 Suppl 1):30-5.
5.
go back to reference Gosch M, Joosten-Gstrein B, Heppner HJ, Lechleitner M. Hyponatremia in Geriatric Inhospital Patients: Effects on Results of a Comprehensive Geriatric Assessment. Gerontology. 2012;58(5):430–40.CrossRef Gosch M, Joosten-Gstrein B, Heppner HJ, Lechleitner M. Hyponatremia in Geriatric Inhospital Patients: Effects on Results of a Comprehensive Geriatric Assessment. Gerontology. 2012;58(5):430–40.CrossRef
6.
go back to reference Soiza RL, Cumming K, Clarke JM, Wood KM, Myint PK. Hyponatremia: Special Considerations in Older Patients. Journal of clinical medicine. 2014;3(3):944–58.CrossRef Soiza RL, Cumming K, Clarke JM, Wood KM, Myint PK. Hyponatremia: Special Considerations in Older Patients. Journal of clinical medicine. 2014;3(3):944–58.CrossRef
7.
go back to reference Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119(1):71.e1-8.CrossRef Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119(1):71.e1-8.CrossRef
8.
go back to reference Gunathilake R, Oldmeadow C, McEvoy M, Kelly B, Inder K, Schofield P, et al. Mild hyponatremia is associated with impaired cognition and falls in community-dwelling older persons. J Am Geriatr Soc. 2013;61(10):1838–9.CrossRef Gunathilake R, Oldmeadow C, McEvoy M, Kelly B, Inder K, Schofield P, et al. Mild hyponatremia is associated with impaired cognition and falls in community-dwelling older persons. J Am Geriatr Soc. 2013;61(10):1838–9.CrossRef
9.
go back to reference Nowak KL, Yaffe K, Orwoll ES, Ix JH, You Z, Barrett-Connor E, et al. Serum Sodium and Cognition in Older Community-Dwelling Men. Clinical journal of the American Society of Nephrology: CJASN. 2018;13(3):366–74.CrossRef Nowak KL, Yaffe K, Orwoll ES, Ix JH, You Z, Barrett-Connor E, et al. Serum Sodium and Cognition in Older Community-Dwelling Men. Clinical journal of the American Society of Nephrology: CJASN. 2018;13(3):366–74.CrossRef
10.
go back to reference Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med. 2013;29(4):737–52.CrossRef Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med. 2013;29(4):737–52.CrossRef
11.
go back to reference Wisdom NM, Mignogna J, Collins RL. Variability in Wechsler Adult Intelligence Scale-IV subtest performance across age. Archives of clinical neuropsychology: the official journal of the National Academy of Neuropsychologists. 2012;27(4):389–97.CrossRef Wisdom NM, Mignogna J, Collins RL. Variability in Wechsler Adult Intelligence Scale-IV subtest performance across age. Archives of clinical neuropsychology: the official journal of the National Academy of Neuropsychologists. 2012;27(4):389–97.CrossRef
12.
go back to reference Babcock H. An experiment in the measurement of mental deterioration. Archives of Psychology. 1930;117:105-. Babcock H. An experiment in the measurement of mental deterioration. Archives of Psychology. 1930;117:105-.
13.
go back to reference Harvey PD. Domains of cognition and their assessment. Dialogues Clin Neurosci. 2019;21(3):227–37.CrossRef Harvey PD. Domains of cognition and their assessment. Dialogues Clin Neurosci. 2019;21(3):227–37.CrossRef
21.
go back to reference Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12.CrossRef Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12.CrossRef
23.
go back to reference Schofield PW, Lee SJ, Lewin TJ, Lyall G, Moyle J, Attia J, et al. The Audio Recorded Cognitive Screen (ARCS): a flexible hybrid cognitive test instrument. J Neurol Neurosurg Psychiatry. 2010;81(6):602–7.CrossRef Schofield PW, Lee SJ, Lewin TJ, Lyall G, Moyle J, Attia J, et al. The Audio Recorded Cognitive Screen (ARCS): a flexible hybrid cognitive test instrument. J Neurol Neurosurg Psychiatry. 2010;81(6):602–7.CrossRef
24.
go back to reference Brinkkoetter PT, Grundmann F, Ghassabeh PJ, Becker I, Johnsen M, Suaréz V, et al. Impact of Resolution of Hyponatremia on Neurocognitive and Motor Performance in Geriatric Patients. Sci Rep. 2019;9(1):12526.CrossRef Brinkkoetter PT, Grundmann F, Ghassabeh PJ, Becker I, Johnsen M, Suaréz V, et al. Impact of Resolution of Hyponatremia on Neurocognitive and Motor Performance in Geriatric Patients. Sci Rep. 2019;9(1):12526.CrossRef
25.
go back to reference Miyazaki T, Ohmoto K, Hirose T, Fujiki H. Chronic hyponatremia impairs memory in rats: effects of vasopressin antagonist tolvaptan. J Endocrinol. 2010;206(1):105–11.CrossRef Miyazaki T, Ohmoto K, Hirose T, Fujiki H. Chronic hyponatremia impairs memory in rats: effects of vasopressin antagonist tolvaptan. J Endocrinol. 2010;206(1):105–11.CrossRef
26.
go back to reference Fujisawa H, Sugimura Y, Takagi H, Mizoguchi H, Takeuchi H, Izumida H, et al. Chronic Hyponatremia Causes Neurologic and Psychologic Impairments. J Am Soc Nephrol. 2016;27(3):766–80.CrossRef Fujisawa H, Sugimura Y, Takagi H, Mizoguchi H, Takeuchi H, Izumida H, et al. Chronic Hyponatremia Causes Neurologic and Psychologic Impairments. J Am Soc Nephrol. 2016;27(3):766–80.CrossRef
27.
go back to reference McEntee WJ, Crook TH. Glutamate: its role in learning, memory, and the aging brain. Psychopharmacology. 1993;111(4):391–401.CrossRef McEntee WJ, Crook TH. Glutamate: its role in learning, memory, and the aging brain. Psychopharmacology. 1993;111(4):391–401.CrossRef
28.
go back to reference Massieu L, Montiel T, Robles G, Quesada O. Brain amino acids during hyponatremia in vivo: clinical observations and experimental studies. Neurochem Res. 2004;29(1):73–81.CrossRef Massieu L, Montiel T, Robles G, Quesada O. Brain amino acids during hyponatremia in vivo: clinical observations and experimental studies. Neurochem Res. 2004;29(1):73–81.CrossRef
29.
go back to reference Anderson CM, Swanson RA. Astrocyte glutamate transport: review of properties, regulation, and physiological functions. Glia. 2000;32(1):1–14.CrossRef Anderson CM, Swanson RA. Astrocyte glutamate transport: review of properties, regulation, and physiological functions. Glia. 2000;32(1):1–14.CrossRef
Metadata
Title
Serum sodium in relation to various domains of cognitive function in the elderly US population
Authors
Sohyae Lee
Jin-young Min
Beom Kim
Sang-Won Ha
Jeohng Ho Han
Kyoung-bok Min
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02260-4

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