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Does being dehydrated relate to faster cognitive decline?

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In 1957 PREDIMED-Plus adults, higher baseline serum osmolarity tracked greater 2-year global cognitive decline, while reported water intake did not.

Source

Water intake, hydration status and 2-year changes in cognitive performance: a prospective cohort study

Nishi SK, Babio N, Paz-Graniel I, et al. · BMC medicine · 2023

doi.org/10.1186/s12916-023-02771-4Read the full paper ↗37 citationscc by

Study at a glance

Design
Cohort — Prospective PREDIMED-Plus analysis of baseline hydration vs 2-year cognition change
N
N=1957 · Adults 55–75 with overweight/obesity and metabolic syndrome
Population
Older Spanish PREDIMED-Plus participants at high CVD risk
Outcome
2-year change in global cognitive function z-score

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Prospectively related baseline serum osmolarity categories and beverage/food water intake (vs EFSA adequacy) to 2-year change in a composite cognition z-score from eight neuropsychological tests, using multivariable linear models.

What they found

Mean total water intake 2871 mL/day; 80.2% met EFSA adequacy, yet 56% were physiologically dehydrated by osmolarity (mean 298 mmol/L). Greater osmolarity associated with worse cognitive change (β −0.010; 95% CI −0.017 to −0.004). Water intake from foods/beverages was not significantly associated with cognitive change.

The limits

What it doesn't show

Observational 2-year follow-up cannot prove that drinking more water prevents dementia; osmolarity may proxy broader illness/medication factors.

Key terms

Serum osmolarity
Blood concentration measure used here as hydration status.
Physiological dehydration
Osmolarity ≥300 mmol/L in this study’s categories.
PREDIMED-Plus
Spanish lifestyle trial cohort of adults with metabolic syndrome.
Global cognitive z-score
Composite summarizing multiple validated cognitive tests.
EFSA water AI
European Food Safety Authority adequate intake references.

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Analytic N:

Common questions

Sample?

1957 adults aged 55–75.

Key exposure?

Serum osmolarity (hydration status).

Main finding?

Higher osmolarity → greater 2-year cognitive decline.

Did intake predict cognition?

No significant association for water intake.