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Sugar in Beverage and the Risk of Incident Dementia, Alzheimer’s disease and Stroke: A Prospective Cohort Study



This study aimed to investigate the association between sugar in beverage and dementia, Alzheimer Disease (AD) dementia and stroke.


This prospective cohort study were based on the US community-based Framingham Heart Study (FHS). Sugar in beverage was assessed between 1991 and 1995 (5th exam). Surveillance for incident events including dementia and stroke commenced at examination 9 through 2014 and continued for 15–20 years.


At baseline, a total of 1865 (63%) subjects consumed no sugar in beverage, whereas 525 (18%) subjects consumed it in 1–7 servings/week and 593 (29%) in over 7 servings/week. Over an average follow-up of 19 years in 1384 participants, there were 275 dementia events of which 73 were AD dementia. And 103 of 1831 participants occurred stroke during the follow-up nearly 16 years. After multivariate adjustments, individuals with the highest intakes of sugar in beverage had a higher risk of all dementia, AD dementia and stroke relative to individuals with no intakes, with HRs of 2.80(95%CI 2.24–3.50) for all dementia, 2.55(95%CI 1.55–4.18) for AD dementia, and 2.11(95%CI 1.48–3.00) for stroke. And the same results were shown in the subgroup for individuals with median intakes of sugar in beverage.


Higher consumption of sugar in beverage was associated with an increased risk of all dementia, AD dementia and stroke.

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Data Availability

Data described in the manuscript, code book, and analytic code will not be made available because the authors are prohibited from distributing or transferring the data and codebooks on which their research was based to any other individual or entity under the terms of an approved NHLBI Framingham Heart Study Research Proposal and Data and Materials Distribution Agreement through which the authors obtained these data.


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The authors thank the National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, Chongqing Mental Health Center and Jiangjin Central Hospital of Chongqing.

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Correspondence to Fei Chen.

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The study procedures followed were in accordance with the ethical standards of the Institutional Review Board and the Principles of the Declaration of Helsinki.

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The authors declare that they have no conflicts of interest.

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None. All authors have read the journal’s authorship agreement and that the manuscript has been reviewed by and approved by all named authors.

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Miao, H., Chen, K., Yan, X. et al. Sugar in Beverage and the Risk of Incident Dementia, Alzheimer’s disease and Stroke: A Prospective Cohort Study. J Prev Alzheimers Dis 8, 188–193 (2021).

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Key words

  • Sugar in beverage
  • dementia
  • Alzheimer disease
  • stroke
  • Framingham Heart Study