Chen Hui, Ding Yihong, Dhana Klodian, Agarwal Puja, Beck Todd, Rajan Kumar B, Melo van Lent Debora, Ma Yuan, Zong Geng, Bjornevik Kjetil, Yuan Changzheng
School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA Psychiatry. 2025 Jun 18. doi: 10.1001/jamapsychiatry.2025.1230.
Intake of sweetened beverages, including sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB), has been linked to multiple health outcomes, but their associations with dementia risk among older adults are unclear.
To assess whether the consumption of SSB and ASB is associated with the risk of all-cause dementia in older adults.
DESIGN, SETTING, AND PARTICIPANTS: This multicohort study examined data from US adults aged 65 and older enrolled in the Health and Retirement Study (2013), the Atherosclerosis Risk in Communities study (1987-1995), the Chicago Healthy and Aging Project (1993-2012), the Rush Memory and Aging Project (1997-2005), the Framingham Heart Study original cohort (1986-1994), and its offspring cohort (1991-2001). Data were analyzed from May 27 to September 24, 2024.
SSB and ASB intake was assessed using validated food frequency questionnaires.
The primary outcome was all-cause dementia ascertained at least 2 years after baseline from active research follow-ups and passive surveillance. Cox proportional hazard regression models were used to assess the associations of SSB and ASB with incident dementia.
Of 10 974 participants (60.0% female, mean [SD] age: 73.2 [6.8] years), 2445 developed incident all-cause dementia over 116 067 person-years of follow-up. Consumption of SSB and ASB in older adulthood was not associated with dementia risk in later life. The pooled hazard ratio (HR) per serving per week for SSB was 0.99 (95% CI, 0.98-1.01; P = .18; I2 = 0%) and for ASB was 1.00 (95% CI, 0.99-1.01; P = .99; I2 = 1%). The pooled HRs comparing the highest (≥1 serving per day) with lowest (0 to <1 serving per month) consumption groups were 0.90 (95% CI, 0.78-1.03) for SSB and 1.00 (95% CI, 0.83-1.21) for ASB. These findings were similar across cohorts and subgroups. In contrast, an inverse association was observed for the Mediterranean diet score (HR, 0.92; 95% CI, 0.85-0.99 per 5-unit increment) as a positive control.
In this study, late-life consumption of SSB or ASB was not associated with the risk of dementia. However, given their detrimental effects on metabolic health and related chronic diseases during early life and midlife, the effects of early-life consumption of SSB and ASB on the risk of dementia warrant further investigation.
摄入含糖饮料，包括含糖汽水（SSB）和人工甜味饮料（ASB），已与多种健康结果相关，但它们与老年人痴呆症风险之间的关联尚不清楚。
评估SSB和ASB的消费是否与老年人全因痴呆症风险相关。
设计、背景和参与者：这项多队列研究检查了参与健康与退休研究（2013年）、社区动脉粥样硬化风险研究（1987 - 1995年）、芝加哥健康与衰老项目（1993 - 2012年）、拉什记忆与衰老项目（1997 - 2005年）、弗雷明汉心脏研究原始队列（1986 - 1994年）及其子代队列（1991 - 2001年）的65岁及以上美国成年人的数据。数据于2024年5月27日至9月24日进行分析。
使用经过验证的食物频率问卷评估SSB和ASB的摄入量。
主要结局是在基线后至少2年通过积极研究随访和被动监测确定的全因痴呆症。采用Cox比例风险回归模型评估SSB和ASB与新发痴呆症之间的关联。
在10974名参与者中（60.0%为女性，平均[标准差]年龄：73.2[6.8]岁），在116067人年的随访期间，有2445人出现新发全因痴呆症。老年人成年期摄入SSB和ASB与晚年痴呆症风险无关。SSB每周每份的合并风险比（HR）为 / 0.99（95%置信区间，0.98 - 1.01；P = 0.18；I² = 0%），ASB为1.00（95%置信区间，0.99 - 1.01；P = 0.99；I² = 1%）。将最高（≥每天1份）与最低（0至<每月1份）消费组进行比较的合并HR，SSB为0.90（95%置信区间，0.78 - 1.03），ASB为1.00（95%置信区间，0.83 - 1.21）。这些发现在各队列和亚组中相似。相比之下，作为阳性对照，观察到地中海饮食评分存在负相关（HR，0.92；每增加5分的95%置信区间，0.85 - 0.99）。
在本研究中，晚年摄入SSB或ASB与痴呆症风险无关。然而，鉴于它们在早年和中年对代谢健康及相关慢性病的有害影响，早年摄入SSB和ASB对痴呆症风险的影响值得进一步研究。
