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Hydration for improved cognitive function

Hydration for improved cognitive function

Despite the general consensus that an functiob level of fluid intake is Cognjtive for functioj [ 21 ], little work has been done Cognitice date to measure the relationship between fluid intake or the hydration status and Diabetes management tips cognitive function. December 20, com to get information about our Brain Fitness Program! Drinking more water can help support a good night's rest. Sawka MN, Cheuvront SN, Carter R Human water needs. Rosinger said the findings suggest older adults may want to pay close attention to their hydration status, by both consuming enough liquids to avoid dehydration as well as ensuring adequate electrolyte balance to avoid overhydration. Google Scholar Fernández-Ballart JD, Piñol JL, Zazpe I, Corella D, Carrasco P, Toledo E, et al.

Hydration for improved cognitive function -

There was no significant relationship between the hydration status and the results of the cognitive function test in the studied population. As the elderly volunteers had a good hydration status, there was no significant relationship between cognitive performance and urine specific gravity. It is necessary to replicate the findings of this study with a larger and more diverse sample of older adults.

Stephanie K. Nishi, Nancy Babio, … Jordi Salas-Salvadó. Hilary J. Bethancourt, W. Larry Kenney, … Asher Y. Susan E. Power, Eibhlís M. Water is a major component of the human body, and its amount varies depending on the body composition, i.

proportion of muscle mass and fat tissue [ 1 ]. As it is a crucial substance for the metabolism, it plays a role as medium of biochemical reactions, in circulation blood, lymph , substrate transport across membranes, temperature regulation, fluid-electrolyte turnover, and internal environment homeostasis [ 2 ]; even mild dehydration is an undesirable condition.

Dehydration can be a result of pathologic fluid loss, diminished water intake, or both of those reasons occurring simultaneously. The elderly are at a higher risk of dehydration than younger adults because of several changes in the organism during ageing, such as a diminished sensation of thirst, lower ability of urine concentration, and sarcopenia diminished muscle mass, which causes a smaller fluid reserve.

Moreover, polypharmacy is a factor, which can increase fluid loss among the elderly, especially when medicines such as diuretics and laxatives are taken [ 3 , 4 ].

A limited fluid intake may also be related to a number of other factors, including physical limitations, such as reduced mobility or incontinence, social isolation or dementia, as well as other illnesses [ 5 ]. Chronic dehydration causes fluid deficits within cells, which can affect the absorption of medications.

Any decrease in the stored body water lowers the plasma volume, which can then decrease the stroke volume and force the body to compensate by raising the heart rate.

A lower plasma volume has an impact on sweating and blood flow to the skin and, therefore, impedes thermoregulation [ 6 ]. Initial symptoms of dehydration are headaches, fatigue and general malaise. Failure of further consumption of sufficient amounts of water leads to the deterioration of cognitive and neurologic functions, organ failure renal , and in extreme cases—death [ 7 ].

On the other hand, cognitive impairment of the elderly, including dementia, is the reason for a decreased probability to meet self-care needs, including a proper fluid intake [ 8 ]. Cognitive functioning in the elderly is associated with many factors, mainly with gender, age and educational level.

In addition, lifestyle smoking, alcohol consumption, physical inactivity and a lack of social support are also related to decline of cognitive function [ 9 ]. A result of dehydration is a worse quality of life; therefore, prevention, early identification and treatment are very important.

There is a lot of information on dehydration among hospitalised and institutionalised elderly, but we only have a small amount of information on the situation in seemingly healthy elderly.

Hence, the aim of the study was to investigate the relation between the hydration status and the cognitive functions among a chosen group of seemingly healthy elderly. The cross-sectional study was conducted in Warsaw Poland , among 60 free-living noninstitutionalised volunteers, aged 60 years and older.

Information about opportunities to participate in the study was distributed by leaflets and was published in the local paper. The study protocol was approved on the 10th of January by the ethical commission of the National Food and Nutrition Institute in Warsaw, Poland. Inclusion criteria were age 60 and above; noninstitutionalised; ability to sign an informed consent to participate in the study.

Exclusion criteria included diagnosed neurodegenerative disease or depression, or being treated with antidepressants; BMI below General information about the respondents was collected with the use of the questionnaire method. The questionnaire contained questions about the socio-economic status, information on the educational level, health status and medical history, selected parameters of lifestyle smoking, alcohol consumption, dietary supplements usage, self-reported physical activity level , as well as information about feelings of thirst, such as the level of the sense of thirst, dryness in the mouth and refreshed feeling after a drink.

The respondents were also asked about the presence of dehydration symptoms headaches, dizziness, weakness , and situations associated with reducing the amount of fluid intake, such as urinary incontinence, difficulty in using the toilet [ 10 ].

Body weight was measured on a calibrated digital scale Seca , Germany in kg with an accuracy of 0. The respondents were asked to stay in light clothing and take their shoes off. Their height was assessed to the nearest 0. According to WHO [ 11 ], a BMI below The blood pressure measurement was done using the standard procedure in a sitting position with the use of an automatic blood pressure monitor Omron M2 Basic.

Data on food intake were gathered during three non-consecutive days 2 weekdays, and 1 weekend day with the use of the 3-day food record method. Individuals received detailed written information on how to fill the questionnaire properly. All participants received a digital kitchen scale with a precision of 1 g.

The diet records were complemented with dietitian interviews. The daily water intake and the energy value of the diets were calculated with the use of the Dieta 5.

software, which contained a food database by Kunachowicz et al. The hydration status was tested by measuring urine specific gravity.

Each respondent received a plastic container for the urine sample with an individual code. Individuals were asked to bring the urine sample for the next meeting and were informed on how to collect urine portion of morning urine, a volume of approximately 50 ml.

The urine was poured into a narrow cylinder of 50 ml volume; then, the urometer was placed inside the cylinder. After the cessation of urometer fluctuations, the relative weight of urine was determined to the bottom meniscus.

The measurement was performed at a temperature of 20—22 °C. A value of urine specific gravity of less than 1. A value higher than 1. The cognitive function was tested using the Mini Mental State Examination MMSE , the Babcock Story Recall Test and the Trail Making Test TMT questionnaires.

The Mini Mental State Examination MMSE is a point questionnaire test that is commonly used to screen for cognitive impairment. It can be used to help diagnose dementia. A score of 28 points or above out of 30 indicates normal cognition, between 24 and 27—MCI mild cognitive impairment , and below 24 can indicate severe, moderate or mild dementia [ 15 ].

The Babcock Story Recall Test is a neuropsychological test of episodic memory. This is a unit story measuring immediate and delayed recall. The total score ranges from 0 to The higher the score, the higher the level of episodic memory [ 16 ].

The Trail Making Test is a neuropsychological test of visual search speed, scanning, speed of processing, mental flexibility and executive. There are two parts of the test. Part A is used to examine cognitive processing speed.

Test B is used to examine executive functioning. The result is the time to complete the task. The shorter the time, the better the cognitive function [ 17 ]. In all subjects, the questionnaire was filled in the same conditions separate room , at the same time of the day, and by the same trained interviewer.

The results were consulted with a psychologist. A short version of the GDS GDS-SF is a subset of 15 questions from the original GDS-LF with the highest correlation with depressive symptoms.

The StatSoft Statistica software version was used for the descriptive and statistical analyses. The characteristics of the population under study were studied in relation to sex Table 1.

Of the 60 individuals, 16 The mean age was The average body mass index was There were statistically significant differences observed between men and women concerning years of education, marital status, self-assessment of health status, presence of a cardiovascular disease, physical activity level, and dietary supplement usage.

Table 2 shows the results of the cognitive function assessment tests and the screening test for depression in the study group. There were no statistically significant differences in the results of all cognitive function tests between genders. Table 3 shows the characteristics of the total study sample concerning factors connected with the hydration status: daily water intake and urine specific gravity.

Women were more likely to implement the recommendations at the AI level. Mean urine specific gravity amounted to 1. Chang T, Ravi N, Plegue MA, Sonneville KR, Davis MM. Inadequate hydration, BMI, and obesity among US adults: NHANES Ann Fam Med.

Download references. We thank all PREDIMED-Plus participants and investigators. CIBEROBN, CIBERESP, and CIBERDEM are initiatives of the Instituto de Salud Carlos III ISCIII , Madrid, Spain.

The Hojiblanca Lucena, Spain and Patrimonio Comunal Olivarero Madrid, Spain food companies donated extra virgin olive oil. The Almond Board of California Modesto, CA , American Pistachio Growers Fresno, CA , and Paramount Farms Wonderful Company, LLC, Los Angeles, CA donated nuts for the PREDIMED-Plus pilot study.

is supported by a postdoctoral fellowship from the Canadian Institutes of Health Research CIHR, MFE CG-M is supported by a predoctoral grant from the University of Rovira I Virgili PMF-PIPF CB is supported by a Juan de la Cierva postdoctoral grant from Ministerio de Ciencia, Innovación y Universidades.

JS-S, the senior author of this paper, was partially supported by ICREA under the ICREA Academia program. for being the conference attendee voted recipient of the Early Career Researcher Award. None of the funding sources took part in the design, collection, analysis, interpretation of the data; writing of the report; or the decision to submit the manuscript for publication.

Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain. Stephanie K. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición CIBEROBN , Institute of Health Carlos III, Madrid, Spain.

Nishi, Nancy Babio, Indira Paz-Graniel, Lluís Serra-Majem, Montserrat Fitó, Dolores Corella, Xavier Pintó, Josep A. Tur, J.

Toronto 3D Diet, Digestive Tract and Disease Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada. Clinical Nutrition and Risk Factor Modification Centre, St.

CIBER de Epidemiología y Salud Pública CIBERESP , Instituto de Salud Carlos III ISCIII , , Madrid, Spain. Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández ISABIAL-UMH , Alicante, Spain. Department of Preventive Medicine, University of Valencia, Valencia, Spain.

Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain.

School of Medicine, Universitat de Barcelona, , Barcelona, Spain. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain.

Instituto de Investigación Biosanitaria Granada, IBS-Granada, Granada, Spain. Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, , Spain.

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Department of Medicine, University of Toronto, Toronto, ON, Canada.

Li Ka Shing Knowledge Institute, St. Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra IdiSNA , University of Navarra, Pamplona, Spain.

You can also search for this author in PubMed Google Scholar. LSM, JV, MF, DC, XP, ABC, JAT, JAM, and JSS contributed to the study concept and design and data extraction from the participants from the PREDIMED-Plus study which provides the framework for the present prospective cohort analysis.

SKN, NB, IPG, CGM, and JSS made substantial contributions to the conception of the present study. SKN performed the statistical analyses and initial interpretation of the data. NB, IPG, CGM, and JSS contributed to the review of the statistical analyses and interpretation of the data.

SKN drafted the manuscript. All authors substantively reviewed the manuscript for important intellectual content and approved the final version to be published. All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Correspondence to Stephanie K. Nishi or Nancy Babio. The PREDIMED-Plus study protocol and procedures were approved by the Research Ethics Committees from each of the participating centers, and the study was registered with the International Standard Randomized Controlled Trial registry ISRCTN; ISRCTN reported receiving grants from Instituto de Salud Carlos III.

reported receiving grants from Instituto de Salud Carlos III, Uriach Laboratories, and Grand-Fountain Laboratories for clinical trial and personal fees from Brewers of Europe, Fundación Cerveza y Salud; Instituto Cervantes in Albuquerque, Milano, and Tokyo; Fundación Bosch y Gimpera; non-financial support from Wine and Culinary International Forum, ERAB Belgium , and Sociedad Española de Nutrición; and fees of educational conferences from Pernaud Richart Mexico and Fundación Dieta Mediterránea Spain.

reported receiving fees of educational conferences from Fundación para la investigación del Vino y la Nutrición Spain. He is a former member of the European Fruit Juice Association Scientific Expert Panel and a former member of the Soy Nutrition Institute SNI Scientific Advisory Committee. He serves or has served as an unpaid member of the Board of Trustees and an unpaid scientific advisor for the Carbohydrates Committee of IAFNS.

He is a member of the International Carbohydrate Quality Consortium ICQC , an Executive Board Member of the Diabetes and Nutrition Study Group DNSG of the EASD, and a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation.

His spouse is an employee of AB InBev. reported receiving research support from the Instituto de Salud Carlos III, Ministerio de Educación y Ciencia, the European Commission, and the USA National Institutes of Health; receiving consulting fees or travel expenses from Instituto Danone and Abbott Laboratories; receiving nonfinancial support from Patrimonio Comunal Olivarero, the Almond Board of California, and Pistachio Growers and Borges S.

A; serving on the board of and receiving grant support through his institution from the International Nut and Dried Foundation and personal fees from Instituto Danone; and serving in the Board of Danone Institute International.

The rest of the authors declared that they have no competing interests. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Hydration and water intake definitions. Table S2. Associations between cognitive assessments and water and fluid intake exposures. Table S3. Associations between cognitive assessments and EFSA fluid intake related guidelines.

Table S4. Associations between cognitive assessments and hydration status. Table S5. Sensitivity analysis in global cognitive function according to water and fluid intake related exposures Table S6.

Sensitivity analysis in global cognitive function according to EFSA fluid intake related guidelines. Table S7. Sensitivity analysis in global cognitive function according to hydration status. Flow diagram of participants.

Continuous sensitivity analysis by sex. Categorical sensitivity analysis by sex. Open Access This article is licensed under a Creative Commons Attribution 4. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.

If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Nishi, S. et al. Water intake, hydration status and 2-year changes in cognitive performance: a prospective cohort study.

BMC Med 21 , 82 Download citation. Received : 02 November Accepted : 06 February Published : 08 March Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Research article Open access Published: 08 March Water intake, hydration status and 2-year changes in cognitive performance: a prospective cohort study Stephanie K.

Nishi 1 , 2 , 3 , 4 , 5 , Nancy Babio 1 , 2 , 3 , Indira Paz-Graniel 1 , 2 , 3 , Lluís Serra-Majem 3 , 6 , Jesús Vioque 7 , 8 , Montserrat Fitó 3 , 9 , Dolores Corella 3 , 10 , Xavier Pintó 3 , 11 , 12 , Aurora Bueno-Cavanillas 7 , 13 , Josep A. Tur 3 , 14 , Laura Diez-Ricote 15 , J. Alfredo Martinez 3 , 16 , 17 , Carlos Gómez-Martínez 1 , 2 , 3 , Andrés González-Botella 18 , Olga Castañer 9 , Andrea Alvarez-Sala 10 , Cristina Montesdeoca-Mendoza 6 , Marta Fanlo-Maresma 3 , 11 , Naomi Cano-Ibáñez 7 , 13 , 19 , Cristina Bouzas 3 , 14 , Lidia Daimiel 3 , 15 , 20 , María Ángeles Zulet 3 , 16 , John L.

Sievenpiper 4 , 5 , 21 , 22 , 23 , 24 , Kelly L. Abstract Background Water intake and hydration status have been suggested to impact cognition; however, longitudinal evidence is limited and often inconsistent. Conclusions Reduced physiological hydration status was associated with greater reductions in global cognitive function over a 2-year period in older adults with metabolic syndrome and overweight or obesity.

Trial registration International Standard Randomized Controlled Trial Registry, ISRCTN Background Cognitive decline is an important public health concern given 55 million people have been diagnosed with dementia and almost 80 million people are projected to be affected by [ 1 ].

Methods Study design This prospective cohort study is based on data collected during the first 2 years of the PREDIMED-Plus PREvención con DIeta MEDiterránea Plus study.

Ethics, consent, and permissions The PREDIMED-Plus study protocol and procedures were approved by the Research Ethics Committees from each of the participating centers, and the study was registered with the International Standard Randomized Controlled Trial Registry ISRCTN; ISRCTN Study participants PREDIMED-Plus participants were recruited from 23 centers across Spain between September and December Assessment of water and fluid intake A validated, semi-quantitative item Beverage Intake Assessment Questionnaire BIAQ [ 10 ] and a item validated semi-quantitative FFQ 38 specifying usual portion sizes, were administered by trained dietitians to assess habitual fluid and dietary intakes, respectively.

Assessment of hydration status Hydration status was estimated based on calculated serum osmolarity SOSM , which is considered a more reliable biomarker of hydration status than urinary markers in older adults [ 44 ].

Results A total of participants mean age Table 1 Baseline characteristics of the participants according to sex, categories of water intake, and hydration status Full size table. Full size image. Discussion To the best of our knowledge, this is the first multi-year prospective cohort study to assess the association between water intake from fluid and food sources and hydration status, with subsequent changes in cognitive performance in older Spanish adults with metabolic syndrome and overweight or obesity.

Conclusions Findings suggest that hydration status, specifically poorer hydration status, may be associated with a greater decline in global cognitive function in older adults with metabolic syndrome and overweight or obesity, particularly in men.

Availability of data and materials The dataset supporting the conclusions of this article is available upon request pending application and approval of the PREDIMED-Plus Steering Committee. References Gauthier S, Rosa-Neto P, Morais JA, Webster C. Article PubMed PubMed Central Google Scholar Scarmeas N, Anastasiou CA, Yannakoulia M.

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Acknowledgements We thank all PREDIMED-Plus participants and investigators. Author information Authors and Affiliations Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain Stephanie K.

Sievenpiper Clinical Nutrition and Risk Factor Modification Centre, St. Alfredo Martinez Centro de Salud Raval de Elche, Alicante, Spain Andrés González-Botella Instituto de Investigación Biosanitaria Granada, IBS-Granada, Granada, Spain Naomi Cano-Ibáñez Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, , Spain Lidia Daimiel Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada John L.

Sievenpiper Department of Medicine, University of Toronto, Toronto, ON, Canada John L. Sievenpiper Li Ka Shing Knowledge Institute, St. Rodriguez Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra IdiSNA , University of Navarra, Pamplona, Spain Zenaida Vázquez-Ruiz Authors Stephanie K.

Nishi View author publications. View author publications. Ethics declarations Ethics approval and consent to participate The PREDIMED-Plus study protocol and procedures were approved by the Research Ethics Committees from each of the participating centers, and the study was registered with the International Standard Randomized Controlled Trial registry ISRCTN; ISRCTN Consent for publication Not applicable.

Competing interests S. Supplementary Information. Additional file 1: Table S1. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4. About this article. Cite this article Nishi, S. Copy to clipboard. It is especially important to be aware of your hydration levels when you are working out.

The more vigorous the workout, the more you should drink as well. So, make sure that you listen to your body and recognize when you are feeling a little foggy, slower in processing, feel a headache coming on, or having trouble with your memory.

If you are interested in learning more about more ways to boost your brain function, visit neurogrow. com to get information about our Brain Fitness Program!

This blog was written by the lead Brain Coach at NeuroGrow, Ms. Emily Scott, and edited by Dr. Majid Fotuhi. Twitter Linkedin Youtube. About Dr. Patient Portal. com Menu. Hydration is Key: Water Your Brain!

Published on December 10, Majid Fotuhi. Here are a few symptoms you may experience when you are not as hydrated as you should be: Memory loss Poor focus and Attention Slow processing of information Irritability Headaches Dr.

Dehydration can Hydratiom some Hydratkon negative funtion on parts of the body, and cofnitive brain is no exception. Here Mental endurance training a few functlon you may improvde when you are not as hydrated imprkved you should be:. Caroline Edmonds and her team performed Hydration for improved cognitive function study Improced the affects of dehydration on brain performance and mood. In addition to their decreased cognitive performance, those who were dehydrated reported being more confused and tense than those who drank water. So, how much water should you be drinking a day to make sure your brain can function well? You may have heard that 8 cups of water a day is the gold standard for hydration. New research from the Institute of Medicine IOMhowever, suggests that the average woman should be drinking about 74 ounces or about 9 cups per day, and the average man should be drinking about ounces or about 13 cups per day.

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