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Cognitive performance in relation to hydration status and water intake among older adults, NHANES 2011–2014

Abstract

Purpose

Risks of dehydration and cognitive decline increase with advancing age, yet the relation between dehydration, water intake, and cognitive performance among older adults remains understudied.

Methods

Using data from the 2011–2014 cycles of the Nutrition and Health Examination Survey (NHANES), we tested if calculated serum osmolarity (Sosm) and adequate intake (AI) of water among women (n = 1271) and men (n = 1235) ≥ 60 years old were associated with scores of immediate and delayed recall, verbal fluency, and attention/processing speed. Sosm was categorized as < 285 (hyperhydrated), 285–289, 290–294, 295–300, or > 300 (dehydrated) mmol/L. AI of water was defined as ≥ 2 L/day for women and ≥ 2.5 L/day for men.

Results

Women with Sosm between 285 and 289 mmol/L scored 3.2–5.1 points higher on the Digit Symbol Substitution test (DSST) of attention/processing speed than women in other Sosm categories (P values < 0.05). There was evidence of a curvilinear relationship between DSST scores and Sosm among women and men (P values for quadratic terms < 0.02). Meeting an alternative AI on water intake of ≥ 1 mL/kcal and ≥ 1500 mL, but not the sex-specific AI, was associated with scoring one point higher on a verbal fluency test (P = 0.02) and two points higher on the DSST (P = 0.03) among women. Significant negative associations between dehydration or inadequate water intake and test scores were not observed among men.

Conclusion

Hydration status and water intake were moderately associated with attention/processing speed among females. Future work should consider the effects of both dehydration and overhydration on cognitive function and investigate potential sex differences in cognitive responses to hydration status.

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References

  1. 1.

    Wilson MM, Morley JE (2003) Impaired cognitive function and mental performance in mild dehydration. Eur J Clin Nutr 57(Suppl 2):S24–S29. https://doi.org/10.1038/sj.ejcn.1601898

  2. 2.

    Grandjean AC, Grandjean NR (2007) Dehydration and cognitive performance. J Am Coll Nutr 26(sup5):549S–554S. https://doi.org/10.1080/07315724.2007.10719657

  3. 3.

    Adan A (2012) Cognitive performance and dehydration. J Am Coll Nutr 31(2):71–78. https://doi.org/10.1080/07315724.2012.10720011

  4. 4.

    Wittbrodt MT, Millard-Stafford M (2018) Dehydration impairs cognitive performance: a meta-analysis. Med Sci Sports Exerc 50(11):2360–2368. https://doi.org/10.1249/mss.0000000000001682

  5. 5.

    Masento NA, Golightly M, Field DT, Butler LT, van Reekum CM (2014) Effects of hydration status on cognitive performance and mood. Br J Nutr 111(10):1841–1852. https://doi.org/10.1017/s0007114513004455

  6. 6.

    Benton D, Young HA (2015) Do small differences in hydration status affect mood and mental performance? Nutr Rev 73(2):83–96. https://doi.org/10.1093/nutrit/nuv045

  7. 7.

    Goodman SPJ, Moreland AT, Marino FE (2019) The effect of active hypohydration on cognitive function: a systematic review and meta-analysis. Physiol Behav 204:297–308. https://doi.org/10.1016/j.physbeh.2019.03.008

  8. 8.

    Mandolesi L, Polverino A, Montuori S, Foti F, Ferraioli G, Sorrentino P, Sorrentino G (2018) Effects of physical exercise on cognitive functioning and wellbeing: biological and psychological benefits. Front Psychol 9:509. https://doi.org/10.3389/fpsyg.2018.00509

  9. 9.

    Caldwell AR, Burchfield J, Moyen NE, Tucker MA, Butts CL, Elbin RJ, Ganio MS (2018) Obesity, but not hypohydration, mediates changes in mental task load during passive heating in females. PeerJ 6:e5394. https://doi.org/10.7717/peerj.5394

  10. 10.

    Malcolm RA, Cooper S, Folland JP, Tyler CJ, Sunderland C (2018) Passive heat exposure alters perception and executive function. Front Physiol 9:585. https://doi.org/10.3389/fphys.2018.00585

  11. 11.

    Benton D (2011) Dehydration influences mood and cognition: a plausible hypothesis? Nutrients 3(5):555–573. https://doi.org/10.3390/nu3050555

  12. 12.

    Lieberman HR (2007) Hydration and cognition: a critical review and recommendations for future research. J Am Coll Nutr 26(sup5):555S–561S. https://doi.org/10.1080/07315724.2007.10719658

  13. 13.

    Drewnowski A, Rehm C, Constant F (2013) Water and beverage consumption among adults in the United States: cross-sectional study using data from NHANES 2005–2010. BMC Public Health 13(1):1068

  14. 14.

    Hooper L (2016) Why, oh why, are so many older adults not drinking enough fluid? J Acad Nutr Diet 116(5):774–778. https://doi.org/10.1016/j.jand.2016.01.006

  15. 15.

    Rosinger A, Herrick K (2016) Daily water intake among US men and women, 2009–2012. NCHS data brief. National Center for Health Statistics, Hyattsville, MD, p 242

  16. 16.

    Rolls B, Phillips P (1990) Aging and disturbances of thirst and fluid balance. Nutr Rev 48(3):137–144

  17. 17.

    Kenney WL, Hodgson JL (1987) Heat tolerance, thermoregulation and ageing. Sports Med 4(6):446–456. https://doi.org/10.2165/00007256-198704060-00004

  18. 18.

    Kenney WL, Tankersley CG, Newswanger DL, Hyde DE, Puhl SM, Turner NL (1990) Age and hypohydration independently influence the peripheral vascular response to heat stress. J Appl Physiol 68(5):1902–1908. https://doi.org/10.1152/jappl.1990.68.5.1902

  19. 19.

    Begg DP (2017) Disturbances of thirst and fluid balance associated with aging. Physiol Behav 178:28–34. https://doi.org/10.1016/j.physbeh.2017.03.003

  20. 20.

    Hooper L, Bunn D, Jimoh FO, Fairweather-Tait SJ (2014) Water-loss dehydration and aging. Mech Ageing Dev 136–137:50–58. https://doi.org/10.1016/j.mad.2013.11.009

  21. 21.

    Armstrong-Esther CA, Browne KD, Armstrong-Esther DC, Sander L (1996) The institutionalized elderly: dry to the bone! Int J Nurs Stud 33(6):619–628. https://doi.org/10.1016/S0020-7489(96)00023-5

  22. 22.

    Marra MV, Simmons SF, Shotwell MS, Hudson A, Hollingsworth EK, Long E, Kuertz B, Silver HJ (2016) Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index. J Acad Nutr Diet 116(5):828–836.e822. https://doi.org/10.1016/j.jand.2015.12.011

  23. 23.

    Hooper L, Bunn DK, Downing A, Jimoh FO, Groves J, Free C, Cowap V, Potter JF, Hunter PR, Shepstone L (2016) Which frail older people are dehydrated? The UK DRIE study. J Gerontol Ser A 71(10):1341–1347. https://doi.org/10.1093/gerona/glv205

  24. 24.

    Lauriola M, Mangiacotti A, D’Onofrio G, Cascavilla L, Paris F, Paroni G, Seripa D, Greco A, Sancarlo D (2018) Neurocognitive disorders and dehydration in older patients: clinical experience supports the hydromolecular hypothesis of dementia. Nutrients 10(5):562. https://doi.org/10.3390/nu10050562

  25. 25.

    Białecka-Dębek A, Pietruszka B (2018) The association between hydration status and cognitive function among free-living elderly volunteers. Aging Clin Exp Res. https://doi.org/10.1007/s40520-018-1019-5

  26. 26.

    Suhr JA, Patterson SM, Austin AW, Heffner KL (2010) The relation of hydration status to declarative memory and working memory in older adults. J Nutr Health Aging 14(10):840–843

  27. 27.

    Ainslie PN, Campbell IT, Frayn KN, Humphreys SM, MacLaren DP, Reilly T (1985) Westerterp KR (2002) Energy balance, metabolism, hydration, and performance during strenuous hill walking: the effect of age. J Appl Physiol 93(2):714–723. https://doi.org/10.1152/japplphysiol.01249.2001

  28. 28.

    Suhr JA, Hall J, Patterson SM, Niinistö RT (2004) The relation of hydration status to cognitive performance in healthy older adults. Int J Psychophysiol 53(2):121–125. https://doi.org/10.1016/j.ijpsycho.2004.03.003

  29. 29.

    Kant A, Graubard B, Atchison E (2009) Intakes of plain water, moisture in foods and beverages, and total water in the adult us population–nutritional, meal pattern, and body weight correlates: national health and nutrition examination surveys 1999–2006. Am J Clin Nutr 90(3):655–663

  30. 30.

    Stookey JD (2005) High prevalence of plasma hypertonicity among community-dwelling older adults: results from NHANES III. J Am Diet Assoc 105(8):1231–1239. https://doi.org/10.1016/j.jada.2005.05.003

  31. 31.

    Centers for Disease Control and Prevention (CDC). National Center for Health Statistics About the National Health and Nutrition Examination Survey. https://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed 22 Feb 2019

  32. 32.

    Brody DJ, Kramarow EA, Taylor CA, McGuire LC (2019) Cognitive performance in adults aged 60 and over: National Health and Nutrition Examination Survey, 2011–2014, vol 126. National Center for Health Statistics, Hyattsville

  33. 33.

    Centers for Disease Control and Prevention (CDC). National Center for Health Statistics (2017) National Health and Nutrition Examination Survey. 2011-2012 data documentation, codebook, and frequencies. Cognitive functioning (cfq_g). https://wwwn.cdc.gov/Nchs/Nhanes/2011-2012/CFQ_G.htm#Component_Description. Accessed Feb 2019

  34. 34.

    Centers for Disease Control and Prevention (CDC). National Center for Health Statistics (2017) National Health and Nutrition Examination Survey. 2013-2014 data documentation, codebook, and frequencies. Cognitive functioning (cfq_h). https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/CFQ_H.htm#Component_Description. Accessed Feb 2019

  35. 35.

    Fillenbaum GG, van Belle G, Morris JC, Mohs RC, Mirra SS, Davis PC, Tariot PN, Silverman JM, Clark CM, Welsh-Bohmer KA, Heyman A (2008) Consortium to Establish a Registry for Alzheimer’s Disease (CERAD): the first twenty years. Alzheimers Dement 4(2):96–109. https://doi.org/10.1016/j.jalz.2007.08.005

  36. 36.

    Wolfsgruber S, Jessen F, Wiese B, Stein J, Bickel H, Mösch E, Weyerer S, Werle J, Pentzek M, Fuchs A, Köhler M, Bachmann C, Riedel-Heller SG, Scherer M, Maier W, Wagner M (2014) The CERAD neuropsychological assessment battery total score detects and predicts Alzheimer disease dementia with high diagnostic accuracy. Am J Geriatr Psychiatry 22(10):1017–1028. https://doi.org/10.1016/j.jagp.2012.08.021

  37. 37.

    Welsh KA, Butters N, Mohs RC, Beekly D, Edland S, Fillenbaum G, Heyman A (1994) Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology 44(4):609–609. https://doi.org/10.1212/wnl.44.4.609

  38. 38.

    Hankee LD, Preis SR, Piers RJ, Beiser AS, Devine SA, Liu Y, Seshadri S, Wolf PA, Au R (2016) Population normative data for the CERAD word list and Victoria Stroop test in younger- and middle-aged adults: cross-sectional analyses from the Framingham Heart Study. Exp Aging Res 42(4):315–328. https://doi.org/10.1080/0361073X.2016.1191838

  39. 39.

    Canning SJD, Leach L, Stuss D, Ngo L, Black SE (2004) Diagnostic utility of abbreviated fluency measures in Alzheimer disease and vascular dementia. Neurology 62(4):556–562. https://doi.org/10.1212/wnl.62.4.556

  40. 40.

    Monsch AU, Bondi MW, Butters N, Salmon DP, Katzman R, Thal LJ (1992) Comparisons of verbal fluency tasks in the detection of dementia of the Alzheimer type. Arch Neurol 49(12):1253–1258. https://doi.org/10.1001/archneur.1992.00530360051017

  41. 41.

    Wechsler D (1997) WAIS-III: Administration and scoring manual. Psychological Corporation, San Antonio

  42. 42.

    Rosano C, Perera S, Inzitari M, Newman AB, Longstreth WT, Studenski S (2016) Digit symbol substitution test and future clinical and subclinical disorders of cognition, mobility and mood in older adults. Age Ageing 45(5):688–695. https://doi.org/10.1093/ageing/afw116

  43. 43.

    Ardila A (2007) Normal aging increases cognitive heterogeneity: analysis of dispersion in WAIS-III scores across age. Arch Clin Neuropsychol 22(8):1003–1011. https://doi.org/10.1016/j.acn.2007.08.004

  44. 44.

    Hooper L, Bunn DK, Abdelhamid A, Gillings R, Jennings A, Maas K, Millar S, Twomlow E, Hunter PR, Shepstone L, Potter JF, Fairweather-Tait SJ (2016) Water-loss (intracellular) dehydration assessed using urinary tests: how well do they work? Diagnostic accuracy in older people. Am J Clin Nutr 104(1):121–131. https://doi.org/10.3945/ajcn.115.119925

  45. 45.

    National Health and Nutrition Examination Survey (2015) 2013–2014 data documentation, codebook, and frequencies. Standard biochemistry profile (biopro_h). https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/BIOPRO_H.htm. Accessed Feb 2019

  46. 46.

    Khajuria A, Krahn J (2005) Osmolality revisited—deriving and validating the best formula for calculated osmolality. Clin Biochem 38(6):514–519. https://doi.org/10.1016/j.clinbiochem.2005.03.001

  47. 47.

    Hooper L, Abdelhamid A, Ali A, Bunn DK, Jennings A, John WG, Kerry S, Lindner G, Pfortmueller CA, Sjöstrand F, Walsh NP, Fairweather-Tait SJ, Potter JF, Hunter PR, Shepstone L (2015) Diagnostic accuracy of calculated serum osmolarity to predict dehydration in older people: adding value to pathology laboratory reports. BMJ Open 5(10):e008846. https://doi.org/10.1136/bmjopen-2015-008846

  48. 48.

    Siervo M, Bunn D, Prado CM, Hooper L (2014) Accuracy of prediction equations for serum osmolarity in frail older people with and without diabetes. Am J Clin Nutr 100(3):867–876. https://doi.org/10.3945/ajcn.114.086769

  49. 49.

    Cheuvront SN, Ely BR, Kenefick RW, Sawka MN (2010) Biological variation and diagnostic accuracy of dehydration assessment markers. Am J Clin Nutr 92(3):565–573. https://doi.org/10.3945/ajcn.2010.29490

  50. 50.

    European Food Safety Association (2010) EFSA panel on dietetic products, nutrition, and allergies (NDA); scientific opinion on dietary reference values for water. EFSA J 8(3):1459

  51. 51.

    Institute of Medicine (2005) Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. The National Academies Press, Washington, DC. https://doi.org/10.17226/10925

  52. 52.

    Begum MN, Johnson CS (2010) A review of the literature on dehydration in the institutionalized elderly. E Spen Eur E J Clin Nutr Metab 5(1):e47–e53. https://doi.org/10.1016/j.eclnm.2009.10.007

  53. 53.

    Ferry M (2005) Strategies for ensuring good hydration in the elderly. Nutr Rev 63(suppl_1):S22–S29. https://doi.org/10.1111/j.1753-4887.2005.tb00151.x

  54. 54.

    Thomas DR, Tariq SH, Makhdomm S, Haddad R, Moinuddin A (2003) Physician misdiagnosis of dehydration in older adults. J Am Med Dir Assoc 4(5):251–254. https://doi.org/10.1097/01.Jam.0000083444.46985.16

  55. 55.

    Filippatos TD, Makri A, Elisaf MS, Liamis G (2017) Hyponatremia in the elderly: challenges and solutions. Clin Interv Aging 12:1957–1965. https://doi.org/10.2147/CIA.S138535

  56. 56.

    Hodgkinson B, Evans D, Wood J (2003) Maintaining oral hydration in older adults: a systematic review. Int J Nurs Pract 9(3):S19–S28. https://doi.org/10.1046/j.1440-172X.2003.00425.x

  57. 57.

    Mentes J (2006) Oral hydration in older adults: greater awareness is needed in preventing, recognizing, and treating dehydration. Am J Nurs 106(6):40–49

  58. 58.

    Perrier E, Demazières A, Girard N, Pross N, Osbild D, Metzger D, Guelinckx I, Klein A (2013) Circadian variation and responsiveness of hydration biomarkers to changes in daily water intake. Eur J Appl Physiol 113(8):2143–2151. https://doi.org/10.1007/s00421-013-2649-0

  59. 59.

    Knight M, Mather M (2013) Look out-it’s your off-peak time of day! Time of day matters more for alerting than for orienting or executive attention. Exp Aging Res 39(3):305–321. https://doi.org/10.1080/0361073X.2013.779197

  60. 60.

    Rosinger AY, Lawman HG, Akinbami LJ, Ogden CL (2016) The role of obesity in the relation between total water intake and urine osmolality in US adults, 2009–2012. Am J Clin Nutr 104(6):1554–1561. https://doi.org/10.3945/ajcn.116.137414

  61. 61.

    Sawka MN, Cheuvront SN, Carter R (2005) Human water needs. Nutr Rev 63(suppl 1):S30–S39. https://doi.org/10.1111/j.1753-4887.2005.tb00152.x

  62. 62.

    Frith E, Loprinzi PD (2018) Physical activity is associated with higher cognitive function among adults at risk for Alzheimer’s disease. Compl Ther Med 36:46–49. https://doi.org/10.1016/j.ctim.2017.11.014

  63. 63.

    Armstrong T, Bull F (2006) Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). J Public Health 14(2):66–70. https://doi.org/10.1007/s10389-006-0024-x

  64. 64.

    US Department of Health and Human Services (2018) Physical activity guidelines for Americans, 2nd edn. US Department of Health and Human Services, Washington, DC

  65. 65.

    Polhuis KCMM, Wijnen AHC, Sierksma A, Calame W, Tieland M (2017) The diuretic action of weak and strong alcoholic beverages in elderly men: a randomized diet-controlled crossover trial. Nutrients 9(7):660

  66. 66.

    Xu W, Wang H, Wan Y, Tan C, Li J, Tan L, Yu J-T (2017) Alcohol consumption and dementia risk: a dose–response meta-analysis of prospective studies. Eur J Epidemiol 32(1):31–42. https://doi.org/10.1007/s10654-017-0225-3

  67. 67.

    Ruxton CHS (2008) The impact of caffeine on mood, cognitive function, performance and hydration: a review of benefits and risks. Nutr Bull 33(1):15–25. https://doi.org/10.1111/j.1467-3010.2007.00665.x

  68. 68.

    Armstrong LE, Pumerantz AC, Roti MW, Judelson DA, Watson G, Dias JC, Sökmen B, Casa DJ, Maresh CM, Lieberman H, Kellogg M (2005) Fluid, electrolyte, and renal indices of hydration during 11 days of controlled caffeine consumption. Int J Sport Nutr Exerc Metab. 15(3):252. https://doi.org/10.1123/ijsnem.15.3.252

  69. 69.

    Killer SC, Blannin AK, Jeukendrup AE (2014) No evidence of dehydration with moderate daily coffee intake: a counterbalanced cross-over study in a free-living population. PLoS One 9(1):e84154. https://doi.org/10.1371/journal.pone.0084154

  70. 70.

    Silva AM, Júdice PB, Matias CN, Santos DA, Magalhães JP, St-Onge M-P, Gonçalves EM, Armada-da-Silva P, Sardinha LB (2013) Total body water and its compartments are not affected by ingesting a moderate dose of caffeine in healthy young adult males. Appl Physiol Nutr Metab 38(6):626–632. https://doi.org/10.1139/apnm-2012-0253

  71. 71.

    Neuhäuser-Berthold M, Beine S, Verwied SC, Lührmann PM (1997) Coffee consumption and total body water homeostasis as measured by fluid balance and bioelectrical impedance analysis. Ann Nutr Metab 41(1):29–36. https://doi.org/10.1159/000177975

  72. 72.

    McLellan TM, Caldwell JA, Lieberman HR (2016) A review of caffeine’s effects on cognitive, physical and occupational performance. Neurosci Biobehav Rev 71:294–312. https://doi.org/10.1016/j.neubiorev.2016.09.001

  73. 73.

    Rosinger AY, Chang A-M, Buxton OM, Li J, Wu S, Gao X (2019) Short sleep duration is associated with inadequate hydration: cross-cultural evidence from US and Chinese adults. Sleep 42(2):1–10. https://doi.org/10.1093/sleep/zsy210

  74. 74.

    Van Dongen HPA, Maislin G, Mullington JM, Dinges DF (2003) The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 26(2):117–126. https://doi.org/10.1093/sleep/26.2.117

  75. 75.

    Zelnick LR, Weiss NS, Kestenbaum BR, Robinson-Cohen C, Heagerty PJ, Tuttle K, Hall YN, Hirsch IB, de Boer IH (2017) Diabetes and CKD in the United States population, 2009–2014. Clin J Am Soc Nephrol 12(12):1984–1990. https://doi.org/10.2215/cjn.03700417

  76. 76.

    Hailpern SM, Melamed ML, Cohen HW, Hostetter TH (2007) Moderate chronic kidney disease and cognitive function in adults 20 to 59 years of age: third National Health and Nutrition Examination Survey (NHANES III). J Am Soc Nephrol 18(7):2205–2213. https://doi.org/10.1681/asn.2006101165

  77. 77.

    Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH (2003) Impact of diabetes on cognitive function among older Latinos: a population-based cohort study. J Clin Epidemiol 56(7):686–693. https://doi.org/10.1016/S0895-4356(03)00077-5

  78. 78.

    Sherzai AZ, Shaheen M, Yu JJ, Talbot K, Sherzai D (2018) Insulin resistance and cognitive test performance in elderly adults: National Health and Nutrition Examination Survey (NHANES). J Neurol Sci 388:97–102. https://doi.org/10.1016/j.jns.2017.11.031

  79. 79.

    Christman AL, Matsushita K, Gottesman RF, Mosley T, Alonso A, Coresh J, Hill-Briggs F, Sharrett AR, Selvin E (2011) Glycated haemoglobin and cognitive decline: the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia 54(7):1645–1652. https://doi.org/10.1007/s00125-011-2095-7

  80. 80.

    Biessels GJ, Despa F (2018) Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol 14(10):591–604. https://doi.org/10.1038/s41574-018-0048-7

  81. 81.

    Koekkoek PS, Kappelle LJ, van den Berg E, Rutten GEHM, Biessels GJ (2015) Cognitive function in patients with diabetes mellitus: guidance for daily care. Lancet Neurol 14(3):329–340. https://doi.org/10.1016/S1474-4422(14)70249-2

  82. 82.

    The International Expert Committee (2009) International expert committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 32(7):1327–1334. https://doi.org/10.2337/dc09-9033

  83. 83.

    National Kidney Foundation (2018) Estimated glomerular filtration rate (eGFR). https://www.kidney.org/atoz/content/gfr. Accessed Sept 2019

  84. 84.

    Levey AS, Stevens LA, Schmid CH, Zhang Y, Castro IIIAF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006

  85. 85.

    Korn EL, Graubard BI (2011) Analysis of health surveys, vol 323. Wiley, Oxford

  86. 86.

    Kempton MJ, Ettinger U, Foster R, Williams SCR, Calvert GA, Hampshire A, Zelaya FO, O’Gorman RL, McMorris T, Owen AM, Smith MS (2011) Dehydration affects brain structure and function in healthy adolescents. Hum Brain Mapp 32(1):71–79. https://doi.org/10.1002/hbm.20999

  87. 87.

    Szinnai G, Schachinger H, Arnaud MJ, Linder L, Keller U (2005) Effect of water deprivation on cognitive-motor performance in healthy men and women. Am J Physiol Regul Integr Comp Physiol 289(1):R275–R280. https://doi.org/10.1152/ajpregu.00501.2004

  88. 88.

    D’Anci KE, Mahoney CR, Vibhakar A, Kanter JH, Taylor HA (2009) Voluntary dehydration and cognitive performance in trained college athletes. Percept Motor Skills 109(1):251–269. https://doi.org/10.2466/pms.109.1.251-269

  89. 89.

    Benton D, Jenkins KT, Watkins HT, Young HA (2016) Minor degree of hypohydration adversely influences cognition: a mediator analysis. Am J Clin Nutr 104(3):603–612. https://doi.org/10.3945/ajcn.116.132605

  90. 90.

    Stachenfeld NS (2014) Hormonal changes during menopause and the impact on fluid regulation. Reprod Sci 21(5):555–561. https://doi.org/10.1177/1933719113518992

  91. 91.

    Vilhena-Franco T, Mecawi AS, Elias LLK, Antunes-Rodrigues J (2016) Oestradiol effects on neuroendocrine responses induced by water deprivation in rats. J Endocrinol 231(2):167. https://doi.org/10.1530/joe-16-0311

  92. 92.

    Santollo J, Myers KE, Rainer IL, Edwards AA (2019) Gonadal hormones in female rats protect against dehydration-induced memory impairments in the novel object recognition paradigm. Horm Behav 114:104547. https://doi.org/10.1016/j.yhbeh.2019.06.011

  93. 93.

    Edmonds C, Crombie R, Gardner M (2013) Subjective thirst moderates changes in speed of responding associated with water consumption. Front Hum Neurosci. https://doi.org/10.3389/fnhum.2013.00363

  94. 94.

    Cheuvront SN, Kenefick RW (2014) Dehydration: physiology, assessment, and performance effects. Compr Physiol 4(1):257–285. https://doi.org/10.1002/cphy.c130017

  95. 95.

    Ferreira-Pêgo C, Guelinckx I, Moreno LA, Kavouras SA, Gandy J, Martinez H, Bardosono S, Abdollahi M, Nasseri E, Jarosz A, Babio N, Salas-Salvadó J (2015) Total fluid intake and its determinants: cross-sectional surveys among adults in 13 countries worldwide. Eur J Nutr 54(2):35–43. https://doi.org/10.1007/s00394-015-0943-9

  96. 96.

    Luckey AE, Parsa CJ (2003) Fluid and electrolytes in the aged. JAMA Surg 138(10):1055–1060. https://doi.org/10.1001/archsurg.138.10.1055

  97. 97.

    Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G (2006) Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med 119(1):71.e71–71.e78. https://doi.org/10.1016/j.amjmed.2005.09.026

  98. 98.

    Nowak KL, Yaffe K, Orwoll ES, Ix JH, You Z, Barrett-Connor E, Hoffman AR, Chonchol M (2018) Serum sodium and cognition in older community-dwelling men. Clin J Am Soc Nephrol 13(3):366–374. https://doi.org/10.2215/cjn.07400717

  99. 99.

    Chung M-C, Yu T-M, Shu K-H, Wu M-J, Chang C-H, Muo C-H, Chung C-J (2017) Hyponatremia and increased risk of dementia: a population-based retrospective cohort study. PLoS One 12(6):e0178977. https://doi.org/10.1371/journal.pone.0178977

  100. 100.

    Fortes MB, Owen JA, Raymond-Barker P, Bishop C, Elghenzai S, Oliver SJ, Walsh NP (2015) Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers. J Am Med Dir Assoc 16(3):221–228. https://doi.org/10.1016/j.jamda.2014.09.012

  101. 101.

    Perrier E, Vergne S, Klein A, Poupin M, Rondeau P, Le Bellego L, Armstrong LE, Lang F, Stookey J, Tack I (2013) Hydration biomarkers in free-living adults with different levels of habitual fluid consumption. Br J Nutr 109(09):1678–1687. https://doi.org/10.1017/S0007114512003601

  102. 102.

    Lemetais G, Melander O, Vecchio M, Bottin JH, Enhörning S, Perrier ET (2018) Effect of increased water intake on plasma copeptin in healthy adults. Eur J Nutr 57(5):1883–1890. https://doi.org/10.1007/s00394-017-1471-6

  103. 103.

    Armstrong LE, Maughan RJ, Senay LC, Shirreffs SM (2013) Limitations to the use of plasma osmolality as a hydration biomarker. Am J Clin Nutr 98(2):503–504. https://doi.org/10.3945/ajcn.113.065466

  104. 104.

    Shirreffs SM (2003) Markers of hydration status. Eur J Clin Nutr 57:S6. https://doi.org/10.1038/sj.ejcn.1601895

  105. 105.

    Shirreffs SM, Merson SJ, Fraser SM, Archer DT (2004) The effects of fluid restriction on hydration status and subjective feelings in man. Br J Nutr 91(6):951–958. https://doi.org/10.1079/bjn20041149

  106. 106.

    Enhörning S, Tasevska I, Roussel R, Bouby N, Persson M, Burri P, Bankir L, Melander O (2017) Effects of hydration on plasma copeptin, glycemia and gluco-regulatory hormones: a water intervention in humans. Eur J Nutr. https://doi.org/10.1007/s00394-017-1595-8

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Correspondence to Hilary J. Bethancourt or Asher Y. Rosinger.

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Bethancourt, H.J., Kenney, W.L., Almeida, D.M. et al. Cognitive performance in relation to hydration status and water intake among older adults, NHANES 2011–2014. Eur J Nutr (2019) doi:10.1007/s00394-019-02152-9

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Keywords

  • Dehydration
  • Water intake
  • Cognitive performance
  • Older adults
  • Serum osmolarity
  • Serum osmolality