Artificial Sweeteners Linked to Faster Cognitive Decline in Midlife Adults

Higher consumption of low- and no-calorie sweeteners (LNCSs) was associated with accelerated cognitive decline, particularly in verbal fluency and global cognition, among adults aged <60 years. This finding from a longitudinal study published in Neurology contributes to a growing body of evidence of the potential long-term neurocognitive effects of artificial and sugar alcohol-based sweeteners.

Researchers analyzed data from 12,772 participants enrolled in the Brazilian Longitudinal Study of Adult Health, followed across 3 study waves between 2008 and 2019. Dietary intake was assessed using a food frequency questionnaire measuring consumption of seven LNCSs, including aspartame, saccharin, acesulfame K, erythritol, xylitol, sorbitol, and tagatose. Cognitive performance was evaluated with 6 standardized tests, and associations were modeled using linear mixed-effects analyses adjusted for demographic and health variables.

Key findings include the following:

• Participants aged <60 years consuming the highest LNCS levels showed faster decline in verbal fluency (β=-0.040; 95% CI -0.064 to -0.016) and global cognition (β=-0.024; -95% CI -0.040 to -0.008).
• No associations were observed among LNCS consumption and cognition in participants aged 60 years or older.
• Individual sweeteners—including aspartame, saccharin, acesulfame K, erythritol, sorbitol, and xylitol—were linked to faster decline in memory and verbal fluency.
• Associations were consistent in both diabetic and nondiabetic subgroups.

While causality cannot be inferred, the results underscore the need for further investigation into the neurological effects of long-term artificial sweetener use.

Source: Gonçalves NG, Martinez-Steele E, Lotufo PA, et al. Association Between Consumption of Low- and No-Calorie Artificial Sweeteners and Cognitive Decline: An 8-Year Prospective Study. Neurology. 2025;105(7):e214023. doi:10.1212/WNL.0000000000214023