Effect of dehydration on cognitive functions
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Warszawski Uniwersytet Medyczny, Polska
Zakład Medycyny Społecznej i Zdrowia Publicznego, Polska
Klaudia Wiśniewska   

Warszawski Uniwersytet Medyczny, Żwirki i Wigury 61, 02-091, Warszawa, Polska
Introduction and objective:
Water is one of the substances that ensure proper functioning of the brain. Dehydration leads to water loss which, in turn, contributes to a number of adverse changes taking place in the body. Dehydration has been shown to have negative effects on health, including cognitive decline. The aim of this article is to present current data on the effect of dehydration on selected cognitive functions and to emphasize the importance of adequate fluid consumption in selected age groups.

Brief description of the state of knowledge:
The results of research published to date show that a significant proportion of the population is in a state of mild dehydration. Analysis of the relationship between dehydration and cognitive functions showed a negative effect in the case of body water loss higher than 2%, regardless of age. A negative effect of dehydration was confirmed primarily on concentration, memory and learning, as well as on selected executive functions. In groups at risk cognitive deterioration may occur much earlier. Based on the analysis of research, age groups may be distinguished that are particularly at risk of insufficient water intake and, therefore, are more liable to dehydration. These groups mainly include infants and young children, as well as the elderly and the sick.

Dehydration exerts a significant impact on cognitive functions; however, this relationship has not yet been fully described. Further research is needed in this area to assess the scale of the potential risk and to formulate more specific recommendations for hydration from the aspect of cognitive functions.

Kavouras SA, Anastasiou CA. Water Physiology, Essentiality, Metabo-lism, and Health Implications. Nutr Today. 2010; 45(6): 27–32.
Scientific Opinion on Dietary Reference Values for water, EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA). EFSA J. 2010; 8(3): 1459.
Asogwa CO, Lai DTH. A review on opportunities to assess hydration in wireless body area networks. Electronics. 2017; 6(4): 1–16.
Merhej R. Dehydration and cognition: an understated relation. Int J Health Policy Manag. 2019; 24(1): 19–30.
Idasiak-Piechocka I. Odwodnienie – patofizjologia i klinika. In Forum Nefrologiczne. 2012; 5(1): 73–78.
Adan A. Cognitive performance and dehydration. J Am Coll Nutr. 2012; 31(2): 71–78.
Benton D, Young HA. Do small differences in hydration status affect mood and mental performance? Nutr Rev. 2015; 73(S2): 83–96.
Kempton MJ, Ettinger U, Foster R, et al. Dehydration affects brain structure and function in healthy adolescents. Hum. Brain Mapp. 2011; 32: 71–79.
Assael BM, Cipolli M, Meneghelli I, et al. Italian children go to school with a hydration deficit. J Nutr Disorders Ther. 2012; 2(3): 1–6.
Gouda Z, Zarea M, El-Hennawy U, et al. Hydration deficit in 9- to 11-year-old Egyptian children. Glob Pediatr Health. 2015; 2: 1–9. eCollection2015.
Trinies V, Chard AN, Mateo T, et al. Effects of water provision and hydration on cognitive function among primary-school pupils in Zam-bia: a randomized trial, PLoS One. 2016; 11(3): e0150071.
Mantantzis K, Drewelies J, Duezel S, et al. Dehydration predicts longi-tudinal decline in cognitive functioning and well-being among older adults. Psychol Aging. 2020; 35(4): 517–528.
Masento NA, Golightly M, Field DT, et al. Effects of hydration status on cognitive performance and mood. Br J Nutr. 2014; 111(10): 1841–1852.
Popkin BM, D’Anci KE, Rosenberg IH. Water, hydration and he-alth, Nutr Rev. 2010; 68(8): 439–458.
Schols JM, de Groot CP, Van der Cammen TJ. Preventing and treating dehydration in the elderly during periods of illness and warm weather. J Nutr Health Aging. 2009; 13(2): 150–157.
Guelinckx I, Frémont-Marquis AS, Eon E, et al. Assessing hydration in children: from science to practice. Ann Nutr Metab. 2015; 66(S3): 5–9.
Kavouras SA, Bougatsas D, Johnson EC, et al. Water intake and urinary hydration biomarkers in children (abstract). Eur J Clin Nutr. 2017; 71(4): 530–535.
Bonnet F, Lepicard EM, Cathrin L, et al. French children start their school day with a hydration deficit. Ann Nutr Metab. 2012; 60(4): 257–263.
Kavouras SA, Johnson EC, Bougatsas D, et al. Validation of a urine color scale for assessment of urine osmolality in healthy children”, Eur J Nutr. 2016; 55(3): 907–915.
Mosiołek A. Metody badań funkcji poznawczych. Psychiatria. 2014; 11(4): 215–221.
Riebl SK, Davy BM. The hydration equation: update on water balance and cognitive performance. ACSMs Health Fit J. 2013; 17(6): 21–28.
Grandjean AC, Grandjean NR. Dehydration and cognitive performance. J Am Coll Nutr. 2007; 26(5): 549S-554S.
Ali HI, Al Dhaheri A S, Elmi F, et al. Water and Beverage Consumption among a Nationally Representative Sample of Children and Adolescents in the United Arab Emirates. Nutrients. 2019; 11(9): 2110.
Iglesia I, Guelinckx I, De Miguel-Etayo PM, et al. Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide. Eur J Nutr. 2015; 54: 57–67.
Stookey JD, König J. Describing water intake in six countries: results of Liq.In7 surveys, 2015–2018. Eur J Nutr. 2018; 57: 35–42.
Kenney EL, Long MW, Cradock AL, et al. Prevalence of inadequate hydration among US children and disparities by gender and race/ethnicity: National Health and Nutrition Examination Survey, 2009–2012. Am J Public Health. 2015; 105: e113–18.
Suh H, Kavouras SA. Water intake and hydration state in children. Eur J Nutr. 2019; 58(2): 475–496.
Drapała N, Piórecka B, Duplaga M. Ocena stanu odżywienia i wystę-powania odwodnienia wśród uczniów i ich matek z miasta i gminy Niepołomice oraz Krakowa. 2020. Repozytorium Uniwersytetu Ja-gielońskiego. (access: 2021.01.05).
Kozioł-Kozakowska A, Piórecka B, Suder A, et al. Body Composition and a School Day Hydration State among Polish Children-A Cross--Sectional Study. Int J Environ Res. Public Health 2020; 17: 7181.
Bar-David Y, Urkin J, Kozminsky E. The effect of voluntary dehydration on cognitive functions of elementary school children. Acta Paediatr. 2005; 94: 1667–73.
Fadda R, Rapinett G, Grathwohl D, et al. Effects of drinking supplemen-tary water at school on cognitive performance in children. Appetite. 2012; 59:730–7.
Khan NA, Raine LB, Drollette ES, et al. The Relationship between Total Water Intake and Cognitive Control among Prepubertal Children. Ann Nutr Metab. 2015; 66(3): 38–41.
Khan NA, Westfall DR, Jones AR, et al. A 4-d Water Intake Intervention Increases Hydration and Cognitive Flexibility among Preadolescent Children. J Nutr. 2019; 149(12): 2255–2264.
D'Anci KE, Constant F, Rosenberg IH. Hydration and cognitive fun-ction in children. Nutr Rev. 2006; 64: 457–464.
Edmonds CJ, Crombie R, Gardner MR. Subjective thirst modera-tes changes in speed of responding associated with water consump-tion. Front Hum Neurosci. 2013; 7: 1–8.
Edmonds CJ, Burford D. Should children drink more water? The ef-fects of drinking water on cognition in children. Appetite. 2009; 52(3): 776–779.
Benton D, Burgess N. The effect of the consumption of water on the memory and attention of children. Appetite. 2009; 53(1): 143–146.
Booth P, Taylor B, Edmonds C. Water supplementation improves visual attention and fine motor skills in schoolchildren. Education for Health. 2012; 30(3): 75–79.
Aphamis G, Stavrinou PS, Andreou E, et al. Hydration status, total water intake and subjective feelings of adolescents living in a hot environment, during a typical school day. Int J Adolesc Med Health. 2019; Apr 5: /j/ijamh.ahead-of-print/ijamh-2018-0230/ijamh-2018-0230.xml.
Wiśniewska K, Wolańska-Buzalska D, Okręglicka K. Woda w żywieniu człowieka – dylematy konsumentów. Przemysł Spożywczy, 2019; 73(10): 40–45.
Jarosz M. Rychlik E, Stoś K, et al. Normy żywieniowe dla populacji Polski i ich zastosowanie. Warszawa: Narodowy Instytut Zdrowia Publicznego – Państwowy Zakład Higieny; 2020.
Komitet Nauki o Żywieniu Człowieka PAN oraz Polskiego Towarzystwa Nauk żywieniowych. Stanowisko zespołu ekspertów: Rola prawidłowe-go nawodnienia w zdrowym żywieniu oraz pożądane zmiany zwyczajów Polaków dotyczących spożycia płynów. Zywienie Czlow Metabol. 2017; XLIV(4): 182–185.
Guelinckx IC, Ferreira-Pêgo LA, Moreno SA, et al. Intake of water and different beverages in adults across 13 countries. Eur J Nutr. 2015; 54: 45–55.
Sharma VM, Sridharan K, Pichan G, et al. Influence of heat-stress induced dehydration on mental functions. 1986; Ergonomics. 29(6): 791–799.
Cian C, Barraud PA, Melin B, et al. Effects of fluid ingestion on cog-nitive function after heat stress or exercise-induced dehydration. Int J Psychophysiol. 2001; 42(3): 243–251.
Szinnai G, Schachinger H, Arnaud MJ, et al. Effect of water deprivation on cognitive-motor performance in healthy men and women. Am J Physiol Regul Integr Comp Physio. 2005; 289: 275–280.
Pross N. Effect of a 24-Hour Fluid Deprivation on Mood and Physio-logical Hydration Markers in Women. Nutr Today. 2012; 47: 35–37.
Stachenfeld NS, Leone CA, Mitchell ES, et al. Water intake reverses dehydration associated impaired executive function in healthy young women. Physiol Behav. 2018; 185: 103–111.
Wittbrodt MT, Millard-Stafford M. Dehydration Impairs Cognitive Performance: A Meta-analysis. Med Sci Sports Exerc. 2018; 50(11): 2360–2368.
Goodman SP, Moreland AT, Marino FE. The effect of active hypohy-dration on cognitive function: A systematic review and meta-analysis. 2019; Physiol Behav. 204: 297–308.
Bennet JA, Thomas V, Riegel B. Unrecognized chronic dehydration in ol-der adults: Examining prevalence rate and risk factors. J Gerontol Nurs. 2004; 30(11): 22–28.
Kim S. Preventable hospitalizations of dehydration: implications of inadequate primary health care in the United States. Ann Epidemiol. 2007; 17: 736.
Mentes J. A typology of oral hydration: problems exhibited by frail nursing home residents. J Gerontol Nurs. 2006; 32(1): 13–19.
Picetti D, Foster S, Pangle AK, et al. Hydration health literacy in the elderly. Nutr Healthy Aging. 2017; 4(3): 227–237.
Telenga A, Rusinowicz T, Życińska K, et al. Odwodnienie u osób w wieku podeszłym – istotny problem kliniczny. Family Med Primary Care Rev. 2012; 3: 434–437.
Volkert D, Kreuel K, Stehle P. Fluid intake of community-living, inde-pendent elderly in Germany-a nationwide, representative study. J Nutr Health Aging. 2005; 9: 305–309.
Białecka-Dębek A, Pietruszka B. The association between hydration status and cognitive function among free-living elderly volunteers. Aging Clin Exp Res. 2019; 31: 695–703.
Bethancourt HJ, Kenney WL, Almeida DM, et al. Cognitive performan-ce in relation to hydration status and water intake among older adults, NHANES 2011–2014. Eur J Nutr. 2020; 59(7): 3133–3148.
Hooper L, Bunn DK, Abdelhamid A, et al. Water-loss (intracellular) dehydration assessed using urinary tests: how well do they work? Diag-nostic accuracy in older people. Am J Clin Nutr. 2016; 104(1): 121–131.