Effect of fluid intake on cognitive function in older individuals: A prospective study

Abstract

Background Adequate fluid intake is essential for maintaining cognitive health in older adults. However, two key questions remain unanswered before recommending increased fluid consumption: (1) whether the relationship between fluid intake and cognitive improvement is linear and (2) the underlying mechanisms that mediate this association. Methods and Findings Thirty-three older adults residing in a geriatric health service facility and receiving nursing care were enrolled in this study. Fluid intake was recorded as part of routine clinical practice. Cognitive function was assessed twice during their stay using the Japanese version of the Mini-Mental State Examination (MMSE-J). Additionally, cerebral blood flow was evaluated bilaterally in the common carotid arteries using ultrasonography, with assessments conducted approximately 82.6 ± 14.9 days apart. Relationships among fluid intake per lean body mass (LBM), changes in MMSE-J scores, and ultrasonographic parameters were analysed using Spearman’s linear correlation analysis with non-parametric bootstrapping. Correlation analyses revealed a positive linear association between fluid intake and improvement in MMSE-J scores [P(FDR) = 0.012] when the intake was less than 42 mL/LBM (kg) per day. Furthermore, fluid intake was inversely correlated with the resistance index in the right common carotid artery [P(FDR) = 0.046], indicating altered cerebral blood dynamics. The main limitations of our study include (1) the inability to evaluate baseline hydration status or fluid intake prior to facility admission due to clinical constraints and (2) the observational design precluding causal inference between fluid intake, cognitive changes, and cerebral blood flow parameters. Conclusions Within moderate intake ranges, fluid consumption was linearly associated with cognitive improvement, an effect that appears to be mediated by changes in cerebral haemodynamic.