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Serum magnesium concentration and incident cognitive impairment: the reasons for geographic and racial differences in stroke study

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Abstract

Purpose

To examine the prospective association between serum Mg level and the incidence of cognitive impairment.

Methods

A random sub-cohort (n = 2063) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort was included in this study. Baseline serum Mg concentration was measured using inductively coupled plasma mass spectrometry. According to the current reference interval of serum magnesium (0.75–0.95 mmol/L), we classified participants below the interval as Level 1 and used it as the referent. The rest of the study population were equally divided into three groups, named Level 2 to 4. Incident cognitive impairment was identified using the Six-Item Screener. Multivariable-adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using logistic regression models.

Results

After adjustment for potential confounders, an inverse threshold association between serum Mg level and incident cognitive impairment was observed. Compared to those with hypomagnesemia (Level 1: < 0.75 mmol/L), the relative odds of incident cognitive impairment was reduced by 41% in the second level [OR (95% CI) = 0.59 (0.37, 0.94)]; higher serum Mg level did not provide further benefits [Level 3 and 4 versus Level 1: OR (95% CI) = 0.54 (0.34, 0.88) and 0.59 (0.36, 0.96), P for linear trend = 0.08].

Conclusions

Findings from this prospective study suggest that sufficient Mg status within the normal range may be beneficial to cognitive health in the US general population.

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Acknowledgements

The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org.

Funding

This study is supported by a research grant from the NIH (R01AG056111). The REGARDS research project is supported by a National Institute of Neurological Disorders and Stroke, National Institutes of Health, and Department of Health and Human Services cooperative agreement U01-NS-041588. Additional support was provided by Centers for Disease Control and Prevention cooperative agreement U01-DP-006302. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke, the National Institutes of Health, the Centers for Disease Control and Prevention, or the Department of Health and Human Services.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA

    Cheng Chen & Ka He

  2. Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA

    Pengcheng Xun

  3. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA

    Frederick Unverzagt

  4. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA

    Leslie A. McClure

  5. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    Marguerite Ryan Irvin

  6. Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    Suzanne Judd

  7. Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA

    Mary Cushman

  8. Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 W 168th Street, Suite 16-62, New York, NY, 10032, USA

    Ka He

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  1. Cheng Chen
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  8. Ka He
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Contributions

KH contributed to study concept and design, and acquisition of data. CC analyzed and interpreted data, and drafted manuscript. All co-authors contributed to critical revision of manuscript for intellectual content.

Corresponding author

Correspondence to Ka He.

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Chen, C., Xun, P., Unverzagt, F. et al. Serum magnesium concentration and incident cognitive impairment: the reasons for geographic and racial differences in stroke study. Eur J Nutr 60, 1511–1520 (2021). https://doi.org/10.1007/s00394-020-02353-7

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  • DOI: https://doi.org/10.1007/s00394-020-02353-7

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