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Impaired cognitive function and mental performance in mild dehydration

Abstract

Dehydration is a reliable predictor of impaired cognitive status. Objective data, using tests of cortical function, support the deterioration of mental performance in mildly dehydrated younger adults. Dehydration frequently results in delirium as a manifestation of cognitive dysfunction. Although, the occurrence of delirium suggests transient acute global cerebral dysfunction, cognitive impairment may not be completely reversible. Animal studies have identified neuronal mitochondrial damage and glutamate hypertransmission in dehydrated rats. Additional studies have identified an increase in cerebral nicotinamide adenine dinucleotide phosphate-diaphorase activity (nitric oxide synthase, NOS) with dehydration. Available evidence also implicates NOS as a neurotransmitter in long-term potentiation, rendering this a critical enzyme in facilitating learning and memory. With ageing, a reduction of NOS activity has been identified in the cortex and striatum of rats. The reduction of NOs synthase activity that occurs with ageing may blunt the rise that occurs with dehydration, and possibly interfere with memory processing and cognitive function. Dehydration has been shown to be a reliable predictor of increasing frailty, deteriorating mental performance and poor quality of life. Intervention models directed toward improving outcomes in dehydration must incorporate strategies to enhance prompt recognition of cognitive dysfunction.

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Jo Ellen Wilson, Matthew F. Mart, … E. Wesley Ely

References

  • Barr BJ (1993): How does a serial, integrated and very limited stream of consciousness emerge from a nervous system that is mostly unconscious, distributed parallel and of enormous capacity? Ciba Found. Symp. 174, 282–290.

    Google Scholar 

  • Beckwith BE, Petros TV & Knutson KK (1990): Effects of DDAVP on gender-specific verbal and visuospatial tasks in healthy young adults. Peptides 11, 1313–1315.

    Article  CAS  Google Scholar 

  • Bernard V, Somogyi P & Bolam JP (1997): Cellular, subcellular and subsynaptic distribution of AMPA-type glutamate receptor subunits in the neostriatum of the rat. J. Neurosci. 17, 819–833.

    Article  CAS  Google Scholar 

  • Bianchi M, Sacerdote P & Panerai AE (1998): Cytokines and cognitive function in mice. Biol. Signals Receptors 7, 45–54.

    Article  CAS  Google Scholar 

  • Buchanan TW & Lovallo (WR2001): Enhanced memory for emotional material following stress-level cortisol treatment in humans. Psychoneuroendocrinology 26, 307–317.

    Article  CAS  Google Scholar 

  • Calabresi P, Centonze D & Bernardi G (2000): Cellular factors controlling neuronal vulnerability in the brain. Neurology 55, 1249–1255.

    Article  CAS  Google Scholar 

  • Calka J, Wolf G & Brosz M (1994): Ultrastructural demonstration of NADPH-diaphorase histochemical activity in the supraoptic nucleus of normal and dehydrated rats. Brain Res. Bull. 34, 301–308.

    Article  CAS  Google Scholar 

  • Chen Q, Patel R, Sales A, Qji G, Kim J, Monreal AW & Brinton RD (2000): Vasopressin-induced neurotrophism in cultured neurons of the cerebral cortex: dependency on calcium signaling and protein kinase activity. Neuroscience 101, 19–26.

    Article  CAS  Google Scholar 

  • Chen Q, Veenman CL & Reiner A (1996): Cellular expression of ionotropic glutamate receptor sub-units on specific striatal neuron types and its implication for striatal vulnerability in glutamate-mediated excitotoxicity. Neuroscience 73, 715–731.

    Article  CAS  Google Scholar 

  • Choi DW & Rothmann SM (1990): The role of glutamate neurotoxicity in hypoxic-ischemic neuronal death. Ann. Rev. Neurosci. 13, 171–182.

    Article  CAS  Google Scholar 

  • Cian C, Barraud PA, Melin B & Raphel C (2001): Effects of fluid ingestion on cognitive function after heat stress or exercise-induced dehydration. Int. J. Psychophysiol. 42, 243–251.

    Article  CAS  Google Scholar 

  • Cian C, Koulmann N, Barraud PA, Raphel C, Jimenez C & Melin B (2000): Influence of variation of body hydration on cognitive function: effect of hyperhydration, heat stress and exercise-induced dehydration. J. Psychophysiol. 14, 29–36.

    Article  Google Scholar 

  • Ciriello J, Hochstenbach SL & Pastor Solano-Flores L (1996): Changes in NADPH diaphorase activity in forebrain structures of the laminae terminalis after chronic dehydration. Brain Res. 708, 167–172.

    Article  CAS  Google Scholar 

  • Cohen S (1983): After effects of stress on human performance during a heat acclimatization regimen. Aviat. Space Environ. Med. 54, 709–713.

    Google Scholar 

  • Dimagl U, Iadecola C & Moskowitz MA (1999): Pathobiology of ischemic stroke: an integrated view. Trends Neurosci. 22, 391–397.

    Article  Google Scholar 

  • Francesconi RP, Sawka MN, Hubbard RW & Pandolf KB (1989): Hormonal regulation of fluid and electrolytes: effects of heat exposure and exercise in the heat. In: Hormonal regulation of fluid and electrolytes. ed. JR Claybaugh & CE Wade, pp 45–85. New York and London: Plenum Press.

    Chapter  Google Scholar 

  • Francis J & Kapoor W (1992): Prognosis after hospital discharge of older medical patients with delirium. J. Am. Geriatr. Soc. 40, 601–606.

    Article  CAS  Google Scholar 

  • Gopinathan PM, Pichan G & Sharma MA (1988): Role of dehydration in heat stress-induced variations in mental performance. Arch. Environ. Health 43, 15–17.

    Article  CAS  Google Scholar 

  • Haddad GG & Jiang C (1993): O2 deprivation in the central nervous system: on the mechanisms of neuronal response, differential sensitivity and injury. Prog. Neurobiol. 40, 277–318.

    Article  CAS  Google Scholar 

  • Häussinger D, Roth E, Lang F & Gerok W (1993): Cellular hydration state: an important determinant of protein catabolism in health and disease. Lancet 341, 1330–1332.

    Article  Google Scholar 

  • Hill AG & Hill GL (1998): Metabolic response to severe injury. Br. J. Surg. 85, 884–890.

    Article  CAS  Google Scholar 

  • Hill AG, Jacobson L, Gonzalez J, Rounds J, Majzoub JA & Wilmore DW (1996): Chronic central nervous system exposure to interleukin-1 beta, but not interleukin-6, mediates catabolism in rats. Am. J. Physiol. 271, R1142–R1148.

    CAS  PubMed  Google Scholar 

  • Hoffman N (1991): Dehydration in the elderly: Insidious and manageable. Geriatrics 46, 35–38.

    CAS  PubMed  Google Scholar 

  • Kinouchi K, Brown G, Pasternak G & Donner DB (1991): Identification and characterization of receptors for tumor necrosis factor-alpha in the brain. Biochem. Biophys. Res. Commun. 181, 1532–1538.

    Article  CAS  Google Scholar 

  • Lee J-M, Zipfel GJ & Choi DW (1999): The changing landscape of ischemic brain injury mechanisms. Nature 399(Suppl), A7–A14.

    Article  CAS  Google Scholar 

  • Leskell LG (1976): Influence of PGE on cerebral mechanisms involved in control of fluid balance. Acta Physiol. Scand. 93, 286.

    Google Scholar 

  • Levkoff S, Safrana C, Cleary P, Gallop J & Phillips R (1988): Identification of factors associated with the diagnosis of delirium in elderly hospitalized patients. J. Am. Geriatr. Soc. 36, 1099–1104.

    Article  CAS  Google Scholar 

  • Lieberman AP, Pitha PM, Shin HS & Shin ML (1989): Production of tumor necrosis factor and other cytokines by astrocytes stimulated with lipopolysaccharide or a neurotropic virus. Proc. Natl. Acad. Sci. USA 86, 6348–6352.

    Article  CAS  Google Scholar 

  • Martin RL, Lloyd HE & Cowan AI (1994): The early events of oxygen and glucose deprivation: setting the scene for neuronal death? Trends Neurosci. 17, 251–257.

    Article  CAS  Google Scholar 

  • Mentes J, Culp K, Wakefield B, Gaspar P, Papp CG, Mobily P & Tripp-Reimer T (1998): Dehydration as a precipitating factor in the development of acute confusion in the frail elderly. In: Hydration and Aging. Facts, Research, and Intervention in Geriatric Series. ed. B Vellas, JL Albarede, PJ Garry, pp 83–98. Paris, New York: Serdi & Springer.

    Google Scholar 

  • Mester M, Carter EA, Tompkins RG, Gelfand JA, Dinarello CA, Burke JF & Clark BD (1994): Thermal injury induces very early production of interleukin-1 alpha in the rat by mechanisms other than endotoxemia. Surgery 115, 588–596.

    CAS  PubMed  Google Scholar 

  • Miller DK, Perry HM & Morley JE (1998): Relationship of dehydration and chronic renal insufficiency with function and cognitive status in older US blacks. In: Hydration and Aging. Facts, Research, and Intervention in Geriatric Series. ed. B Vellas, JL Albarede, PJ Garry, pp 149–159. New York: Serdi and Springer.

    Google Scholar 

  • Murray A, Levkoff S, Wetle T, Beckett L, Cleary P, Schor J, Lipsitz B, Rowe J & Evans D (1993): Acute delirium and functional decline in the hospitalized elderly patient. J. Gerontol. Sci. 48, M181–M186.

    Article  CAS  Google Scholar 

  • Neelon V & Champagne M (1992): Managing cognitive impairment: The current bases for practice. In: Key Aspects of Eldercare: Managing falls, incontinence and cognitive impairment. eds. S Funk, E Tournquist, M Champagne, pp 122–131. New York: Springer.

    Google Scholar 

  • Newcomer JW, Selke G, Melson AK, Hershey T, Craft S, Richards K & Alderson AL (1999): Decreased memory performance in healthy humans induced by stress-level cortisol treatment. Arch. Gen. Psychiatry 56, 527–533.

    Article  CAS  Google Scholar 

  • Noda Y, Yamada K & Nabeshima T (1997): Role of nitric oxide in the effect of aging on spatial memory in rats. Behav. Brain Res. 83, 153–158.

    Article  CAS  Google Scholar 

  • Obrenovitch TP & Urenjjak J (1994): Altered glutamatergic transmission in neurological disorders: from high extracellular glutamate to excessive synaptic efficacy. Prog. Neurobiol. 51, 39–87.

    Article  Google Scholar 

  • Rennie MJ, MacLennan PA, Hundal HS, Weryk B, Smith K, Taylor PM, Egan C & Watt PW (1989): Skeletal muscle glutamine transport, intramuscular glutamine concentration, and muscle-protein turnover. Metabolism 38, 47–51.

    Article  CAS  Google Scholar 

  • Rolls BJ & Phillips PA (1990): Aging and disturbances of thirst and fluid balance. Nutr. Rev. 48, 137–144.

    Article  CAS  Google Scholar 

  • Salemme E, Diano S, Maharajan P & Maharajan V (1996): Nitric oxide, a neuronal messenger. Its role in hippocampal plasticity. Riv. Biol. 89, 87–107.

    CAS  PubMed  Google Scholar 

  • Sharma VM, Sridharan K, Pichan G & Panwar MR (1986): Influence of heat stress-induced dehydration on mental functions. Ergonomics 29, 791–799.

    Article  CAS  Google Scholar 

  • Silver AJ (1987): Aging and risks for dehydration. Cleveland Clin. J. Med. 57, 341–344.

    Article  Google Scholar 

  • Tallaksen-Greene SJ & Albin RL (1996): Splice variants of glutamate receptor sub-units 2 and 3 in striatal projection neurons. Neuroscience 75, 1057–1064.

    Article  CAS  Google Scholar 

  • Vedhara K, Hyde J, Gilchrist ID, Tytherleigh M & Plummer S (2000): Acute stress, memory, attention and cortisol. Psychoneuroendocrinology 25, 535–549.

    Article  CAS  Google Scholar 

  • Warren JL, Bacon WE, Harris T, McBean AM, Foley DJ & Phillips C (1994): The burden and outcomes associated with dehydration among US elderly. Am. J. Pub. Health 84, 1265–1269.

    Article  CAS  Google Scholar 

  • Weitzman RE & Kleeman CR (1979): The clinical physiology of arginine vasopressin secretion and thirst. West. J. Med. 131, 373–400.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Yamamoto M, Share L & Shade RE (1976): Vasopressin release during ventriculocisternal perfusion with Prostaglandin E2 . J. Endocrinol. 71, 325.

    Article  CAS  Google Scholar 

Download references

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Guarantor: Margaret-Mary G Wilson.

Contributors: M-MGW reviewed the articles, analyzed the data, drafted and edited the manuscript. Both authors were involved in critical revision of the manuscript and approved the final version submitted.

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Correspondence to M-M G Wilson.

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

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