Does Calcium and Magnesium Deficiency Increase Risk of Cognitive Decline?

Protecting cognition is a key clinical goal for many patients. Clinicians may be quick to consider specialized herbs such as lion’s mane and ginkgo biloba or nutrients such as phosphatidyl serine and citicoline; however, new research adds magnesium and calcium to the short list.

Published in the journal Nutrients, researchers found that low levels of both magnesium and calcium were associated with poor cognitive performance in people over age 60.

“This new study is intriguing and informative in that it corroborates what we already assume with magnesium and it adds low calcium to our radar,” said Tina Kaczor, ND, FABNO, who is the editor-in-chief of the Natural Medicine Journal. “The role of magnesium in normalizing neurotransmitters as well as influencing mitochondrial health of brain cells is well known, and magnesium deficiency is associated with cognitive impairment in several other studies.”

According to a mini review from this year, the neuroprotective effects of magnesium have been substantiated and inadequate magnesium can result in increased neuroinflammation and cognitive decline. That conclusion is consistent with a cross-sectional study published last year showing that low magnesium levels are associated with mild cognitive impairment in adults aged 55 or older.

While the association with magnesium is not surprising, the fact that low calcium is linked to poor cognition is not as clear-cut.

“Calcium is thought to be damaging to the brain when its high in the serum, but the effects of low calcium are less well known,” said Dr. Kaczor. “This study does not clarify whether low calcium is a surrogate marker of low albumin or even low vitamin D. The paper also does not share albumin levels, which could be used to determine free calcium levels using the calcium correction equation.” Dr. Kaczor also points out that ionic calcium levels would be a more reliable measure of available calcium.

According to the Diabetes Outcomes Study published last year, there is a clear association between increased coronary artery calcium and cognitive decline in patients with prediabetes. In addition, an earlier study found no association between high serum ionized calcium levels and cognition.

In this latest study, both low magnesium and low calcium levels were associated with reduced cognitive performance, which makes it the first study to look at concurrent serum concentrations of these two minerals. The researchers conclude, “Hypomagnesemia and hypocalcemia appear to independently and adversely affect the cognitive performance of older individuals, with a potential additive effect when both deficiencies co-occur. These findings underscore the necessity of monitoring nutritional levels and ion concentrations in advanced-age patients to prevent cognitive deterioration.”

Research also indicates that the proper balance of calcium to magnesium in the diet may impact dementia risk, showing that a calcium to magnesium ratio of ≤1.69 and magnesium intake >267.5 mg/day was related to an increased risk for dementia.

While more research may be needed to confirm the role low and high levels of calcium play in the development or prevention of dementia, this latest study adds low calcium to the list of possible concerns when it comes to cognitive decline.

“As always, addressing the root cause of nutrient deficiencies is part of a sound integrative medicine plan,” concluded Dr. Kaczor. “This study gives us yet another reason to test and address ongoing nutrient deficiencies in our patients.”