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The relationship between dehydration and etiologic subtypes of major neurocognitive disorder in older patients

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Key summary points

AbstractSection Aim

The purpose of the study was to assess the relationship between etiologic subtypes of major neurocognitive disorder (MND) and dehydration, and the frequency of dehydration with a particular emphasis on different MND (dementia) subtypes.

AbstractSection Findings

The prevalence of dehydration is 58% in patient with MND and 53% in patients without MND. Dehydration is associated with dementia. Hypertension, diabetes mellitus, chronic kidney disease, dysphagia and cognitive dysfunction were associated with dehydration in patients with dementia. The prevalence of dehydration is highest in patients with vascular dementia, although particular dementia subtypes do not appear to be significantly associated with dehydration compared to patients with normal cognition.

AbstractSection Message

Dehydration is common not only in etiologic MND subtypes, but also in patients without dementia. Hydration status should be evaluated in older adults irrespective of neurocognitive status. Some comorbidities, dysphagia and severity of cognitive dysfunction may increase the risk of dehydration in patients with dementia.

Abstract

Purpose

Studies investigating associations between etiologic subtypes of major neurocognitive disorder (MND) and dehydration frequency are lacking. The aim of this study was to investigate the prevalence and risk factors of dehydration among older adults with and without MND (dementia), and across different etiologic subtypes of MND.

Methods

This cross-sectional study included adults aged ≥ 65 years old from one geriatric outpatient clinic. Dehydration was defined as a calculated [1,86 × (Na + K) + 1,15 × glucose + urea + 14] plasma osmolarity of > 295 mOsm/L.Clinical characteristics and measures of comprehensive geriatric assessments of patients with dehydration and normohydration were compared. MND was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition criteria. The underlying etiologic subtypes were determined by specific diagnostic criteria.

Results

Of the 1377 patients 72% were female, the mean age was 80 ± 8 years, and 575 had dementia. Dehydration was more common in patients with dementia than those without dementia (58% vs. 53%, p = 0.044). The prevelance of dehydration was 57%, 62%, 54%, 57% and 68% in Alzheimer’s disease, Parkinson’s disease dementia, fronto-temporal dementia, dementia with Lewy bodies, and vascular dementia, respectively (p ≥ 0.05). MND was associated with dehydration (OR 1.26, 95% CI 1.01–1.57; p = 0.037) after adjustment for age and sex. In multivariable analysis, among patients with dementia, hypertension, DM, CKD, and dysphagia were more common while mean Mini-Mental State Examination score was lower in those who had dehydration versus no dehydration in older patients with dementia (p < 0.05).

Conclusion

Dehydration is slightly associated with the presence of MND independent of age and sex. However, dehydration is also quite common in older patients without cognitive disorders. Therefore, hydration status should be monitored in older adults irrespective of neurocognitive status. Hypertension, DM, CKD, dysphagia and severity of cognitive dysfunction were associated with dehydration in patients with dementia. The prevalence of dehydration is highest in patients with vascular dementia.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Damla Aslan Kirazoglu & Kübra Atcıyurt

  2. Division of Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Cihan Heybeli

  3. Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093, Fatih, Istanbul, Turkey

    Veliye Yigitalp & Pinar Soysal

  4. Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK

    Lee Smith

  5. Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy

    Nicola Veronese

  6. Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran

    Masoud Rahmati

  7. Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran

    Masoud Rahmati

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  1. Damla Aslan Kirazoglu
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  8. Pinar Soysal
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Damla Aslan Kirazoglu], [Kubra Atciyurt], [Veliye Yigitalp], and [Pinar Soysal]. The first draft of the manuscript was written by [Cihan Heybeli], [Damla Aslan Kirazoglu], [Kubra Atciyurt], [Veliye Yigitalp], [Lee Smith], [Nicola Veronese], and [Masoud Rahmati] All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pinar Soysal.

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The authors did not receive support from any organization for the submitted work. The authors have no relevant financial or non-financial interests to disclose.

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This study included human participants, is conformed to the Declaration of Helsinki and was approved by the local ethics committee.

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Aslan Kirazoglu, D., Heybeli, C., Atcıyurt, K. et al. The relationship between dehydration and etiologic subtypes of major neurocognitive disorder in older patients. Eur Geriatr Med (2024). https://doi.org/10.1007/s41999-024-00986-z

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