The relationship between low-sodium salt substitutes and cognitive function among middle-aged and older adults: The Chinese Square Dance Cohort

BackgroundPrevious studies have indicated that high sodium intake is associated with poorer cognitive function, and low-sodium salt substitutes (LSSS) can reduce sodium intake.ObjectiveWe hypothesized that the use of LSSS is linked to better cognitive performance.MethodsIn this cross-sectional study, participants reported using LSSS or regular salt via questionnaire. Cognitive function was evaluated using Auditory Verbal Learning Test (AVLT), Verbal Fluency Test (VFT), Digit Symbol Substitution Test (DSST), and Trail Making Test-B (TMT-B). Z-scores were utilized to standardize the results, with composite z-score reflecting global cognitive function. Mild cognitive impairment (MCI) was determined by Petersen's criteria, and subclassified into amnestic MCI (aMCI) and non-amnestic MCI (naMCI). Multiple linear regression and logistic regression analyses were performed to assess the associations of the use of LSSS with cognitive function and MCI.ResultsAmong 4201 participants (median age 64 years, 85.91% female), 639 (15.21%) self-reported using LSSS. Compared to those who used regular salt, the use of LSSS was associated with higher composite z-score, VFT, and DSST, with β values (95%CIs) of 0.10 (0.05, 0.15), 0.16 (0.08, 0.24), and 0.17 (0.10, 0.23), respectively. The prevalence of MCI was 8.29% in the LSSS group and 12.80% in the regular salt group, the use of LSSS was related to lower odds of naMCI (OR = 0.63, 95%CI: 0.41, 0.96).ConclusionsOur findings indicate that the use of LSSS was related to better cognitive performance and lower odds of naMCI, suggesting that replacing regular salt with LSSS may be a promising dietary strategy for cognitive aging worthy of further investigation.