IMPORTANCE

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.

OBJECTIVE

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.

EXPOSURES

SSB and ASB intake was assessed using validated food frequency questionnaires.

MAIN OUTCOMES AND MEASURES

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.

RESULTS

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.

CONCLUSIONS AND RELEVANCE

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.