Americans trying to stay healthy have abandoned sugary drinks for diet drinks in droves over the past few decades on the theory that the latter is better than the former. Now, more evidence has emerged to refute that rationale.

Indeed, a new study shows an association between diet soda and both stroke and dementia, with people drinking diet soda daily being almost three times as likely to develop stroke and dementia as those who consumed it weekly or less.

“This included a higher risk of ischemic stroke, where blood vessels in the brain become obstructed and Alzheimer’s disease dementia, the most common form of dementia,” said Matthew Pase, a Boston University School of Medicine neurologist and the lead author of the study published in the journal Stroke.

While emphasizing that the research did not show causation, only a correlation, Pase said in a video explaining the study that diet drinks “might not be a healthy alternative.”

The authors of the study noted its many limitations. The main limitation, Pase said, is the important point that an observational study like this cannot prove that drinking artificially-sweetened drinks is linked to strokes or dementia, but it does identify an intriguing trend that will need to be explored in other studies.

Still, people should be “cautious” about their intake of diet sodas, Pase said, noting that more study is needed.

And they should most definitely not retreat to sugary drinks, he said. They have been associated not only with obesity and its consequences, such as diabetes, but with poorer memory and smaller overall brain volumes.