Researchers have found that while drinking sugary beverages frequently may lead to poorer memory, daily intake of diet soda may increase the risk of stroke and dementia.
One stroke expert said the findings are far from definitive.
Still, people should be "cautious" about their intake of diet sodas, Pase said, noting that more study is needed. "Similarly, stroke is rare in people aged under 45 and so we focused on people older than age 45 for stroke".
The team from Boston University School of Medicine looked at ten years' worth of data from more than 4,300 people.
After adjusting for factors that could influence the results, such as age, sex, education, calorie intake, exercise and smoking, people who had at least one diet drink a day had an nearly three times increased risk of dementia or stroke.
Matthew Pase, senior fellow in the department of neurology at Boston University School of Medicine, said: "Our study shows a need to put more research into this area given how often people drink artificially sweetened beverages". They then followed up with the participants for the next 10 years to see who developed stroke or dementia and then compared dietary habits to the risk of developing these health problems.
"Just because they say "diet" doesn't mean they're a healthy alternative to sugary drinks".
"The FDA, World Health Organization, European Food Safety Authority and others have extensively reviewed low-calorie sweeteners and have all reached the same conclusion - they are safe for consumption", the statement said.
In addition to being an observational study which can not prove cause and effect, the authors note the study several other limitations, including that the overwhelming majority of participants were white. However, the impact on stroke risk remained.
Diet drinks contain next-to-no calories, because they use artificial sweeteners that are hundreds, sometimes thousands of times sweeter than sugar.
The researchers didn't find any link between sugary beverages and either the stroke or dementia, but even it is not encouraged to drink those either.
"We believe the pathways of which artificially sweetened beverages would affect the brain are probably through vascular mechanisms", Sacco said.
And Dr James Pickett, of the Alzheimer's Society, added: "This research does not show that artificially sweetened drinks cause dementia". "Many strokes are caused by hardening of arteries; and the risk of dementia is also increased by the hardening of arteries in large and small vessels".
Research has long shown that artificially sweetened drinks are not health drinks. Some of those in the diet drinks were likely saccharin, acesulfame, aspartame, neotame, or sucralose, the researchers said.
"A lot of people assume they must be healthy choices because they are not sugared beverages, but the critical thing for people to understand is we don't have the evidence", Prof Susan Swithers, from the US's Purdue Universitytold the BBC.
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