Extracellular to Intracellular Body Water and Cognitive Function among Healthy Older and Younger Adults

Lee, Jinhyun; Shields, Richard K.

doi:10.3390/jfmk7010018

Cited by 6 publications

(6 citation statements)

References 47 publications

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“…Therefore, they might not yet have substantial changes in physical activity or nourishment and thus did not experience solid changes in body composition. Furthermore, age was reported to be an important factor to influence the fluctuation of cellular water distribution, such that ECW to ICW ratio increases with age and might be due to the steeper decrease in the ICW content than in the ECW compartment ( 9 , 50 ). After controlling for age and other covariates, most body composition variables became insignificant; only segmental BIA variables such as resistance and reactance in the lower extremities and the related body composition/water compartment variables such as SL_lower and SW_lower remained to be significantly associated with the incidence of MCI.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, MCI patients of both sexes had just a slightly lower phase angle than the normal controls, and this difference disappeared after controlling for covariates in both women and men; the muscle quality expressed by phase angle might not be a sensitive marker of cognitive impairment in its early stage. Moreover, ECW/ICW is another sensitive parameter that is positively correlated with age as well as cognitive function such as executive function, inhibition, or attention ability in elderly people ( 9 , 50 ). In this study, after controlling for age, sex and the comorbidities, ECW/ICW in upper and lower extremities showed a tendency of associations with MCI prevalence.…”

Section: Discussionmentioning

confidence: 99%

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Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment

Doan

Kim

et al. 2022

Front. Nutr.

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ObjectiveTo examine the changes in body composition, water compartment, and bioimpedance in mild cognitive impairment (MCI) individuals.MethodsWe obtained seven whole-body composition variables and seven pairs of segmental body composition, water compartment, and impedance variables for the upper and lower extremities from the segmental multi-frequency bioelectrical impedance analysis (BIA) of 939 elderly participants, including 673 cognitively normal (CN) people and 266 individuals with MCI. Participants’ characteristics, anthropometric information, and the selected BIA variables were described and statistically compared between the CN participants and those with MCI. The correlations between the selected BIA variables and neuropsychological tests such as the Korean version of the Mini-Mental State Examination and Seoul Neuropsychological Screening Battery – Second Edition were also examined before and after controlling for age and sex. Univariate and multivariate logistic regression analyses with estimated odds ratios (ORs) were conducted to investigate the associations between these BIA variables and MCI prevalence for different sexes.ResultsParticipants with MCI were slightly older, more depressive, and had significantly poorer cognitive abilities when compared with the CN individuals. The partial correlations between the selected BIA variables and neuropsychological tests upon controlling for age and sex were not greatly significant. However, after accounting for age, sex, and the significant comorbidities, segmental lean mass, water volume, resistance, and reactance in the lower extremities were positively associated with MCI, with ORs [95% confidence interval (CI)] of 1.33 (1.02–1.71), 1.33 (1.03–1.72), 0.76 (0.62–0.92), and 0.79 (0.67–0.93), respectively; with presumably a shift of water from the intracellular area to extracellular space. After stratifying by sex, resistance and reactance in lower extremities remained significant only in the women group.ConclusionAn increase in segmental water along with segmental lean mass and a decrease in body cell strength due to an abnormal cellular water distribution demonstrated by reductions in resistance and reactance are associated with MCI prevalence, which are more pronounced in the lower extremities and in women. These characteristic changes in BIA variables may be considered as an early sign of cognitive impairment in the elderly population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment

Doan

Kim

et al. 2022

Front. Nutr.

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“…In addition, two cross-sectional studies in patients of type 2 diabetes and in healthy elderly participants respectively showed that higher ECW/TBW or ECW/ICW was independently associated with poorer cognitive function. 23,24 However, the data from us and another study suggested that no significant association between cognitive function and ECW or ECW/ TBW. 25 This discrepancy might be related to the instability of fluid status in HD patients, different races, and different cognitive assessment methods.…”

Section: Discussionmentioning

confidence: 66%

Low intracellular water and incident cognitive impairment in chronic hemodialysis patients

Tian,

Yuan,

et al. 2023

Int J Geriat Psychiatry

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ObjectiveTo explore the effect of intracellular water (ICW) evaluated by the bioelectrical Impedance Spectroscopy (BIS) on the risk of incident cognitive impairment (CI) in chronic hemodialysis (HD) patients.MethodsThree thousand three hundred eighty‐five patients were recruited and monitored prospectively for up to 3 years (the median follow‐up time, 2 years) in this observational cohort study. Mini‐Mental State Examination score (MMSE) was used to assess the global cognitive function. ICW was measured by body composition monitor based on BIS. Multiple Cox regression models, stratified analyses, and interactive analyses were conducted.ResultsDuring the follow‐up period, 1256 patients (37.1%) experienced incident CI. The incidence of CI was increased with decreasing quartiles of ICW (27.4%, 32.2%, 38.9%, and 50.1% for the fourth, third, second, and first quartiles, respectively). Decreased ICW was significantly associated with incident CI. The association remained statistically significant even after adjusting for age, sex, education, albumin, C‐reactive protein, residual renal function and various medical histories. The hazard ratios were 1.38 (1.17–1.64) and 1.28 (1.08–1.52) for ICW quartile 1 and quartile 2, respectively (reference, quartile 4). The association stably existed across subgroups, and the residual renal function had an interactive role in the association between ICW and incident CI (p = 0.014).ConclusionLow baseline ICW was an independent risk factor for CI in chronic HD patients. Our finding highlights the necessity of using BIS to measure body composition when assessing the risk of CI in HD patients.

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“…Moreover, we found an abnormal cellular water distribution as demonstrated by the decrease in ICW_ECW ratio in CP individuals compared to the non-CP individuals. ICW_ECW has been considered a prognostic factor of several pathological conditions such as edema, sarcopenia, cancer, and cognitive decline, and is associated with muscle strength and gait speed in older populations ( 27 , 63 – 66 ). Decreased ICW_ECW suggests more serious reduction in the intracellular area water compared to that in the extracellular space and might have been caused by the lower BCM, body cell volume, or a malnutrition status in the CP individuals.…”

Section: Discussionmentioning

confidence: 99%

Segmental bioelectrical impedance analysis for Korean older population with cold pattern

Doan

Kim

et al. 2022

Front. Nutr.

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ObjectiveThis study examined the association of whole-body composition and segmental bioimpedance variables with cold pattern (CP) in different sexes.MethodsWe assigned 667 older individuals to a CP group (n = 488) and a non-CP group (n = 179) by using an eight-item self-administered questionnaire. Seven body composition variables and three pairs of segmental bioimpedance variables for the upper and lower extremities, which were obtained from a segmental multifrequency bioimpedance analyzer, were employed to investigate their association with CP. Participants’ characteristics were first described. Then we compared the selected body composition and bioimpedance variables between the CP and non-CP groups. Finally, their association with CP was investigated using univariate and multivariate regression analyses. All analyses were performed separately for women and men.ResultsBoth women and men exhibited a comparable mean age in the CP and non-CP groups; however, women with CP had significantly lower blood pressures, whereas men with CP showed a higher proportion of osteoarthritis than those without CP. Compared with the non-CP group, individuals with CP exhibited significantly smaller body sizes indicated by shorter height and smaller weight, lower body mass index, and smaller volume-to-body surface area ratio in both sexes. After controlling for age, height, weight, and other covariates, we found significant reductions in body lean mass such as fat-free mass and body cell mass, basal metabolic rate per unit mass, total body water, and intra-to-extracellular water ratio in the CP group. With regard to segmental bioimpedance analysis, the resistance ratios and phase angles in the upper and lower extremities yield significant associations with CP incidence, as demonstrated by the odds ratio (95% confidence interval) of 1.72 (1.16–2.57), 1.69 (1.18–2.48), 0.60 (0.40–0.89), and 0.57 (0.39–0.82), respectively. However, these results did not emerge in men.ConclusionAbnormal cellular water distribution and deterioration in body cell mass and/or cell strength are associated with CP prevalence, regardless of age, height, weight. These findings are similar in the upper and lower extremities and are more pronounced in women. The abovementioned patterns may be considered effective indicators for identifying CP in the older adult population.

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Extracellular to Intracellular Body Water and Cognitive Function among Healthy Older and Younger Adults

Cited by 6 publications

References 47 publications

Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment

Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment

Low intracellular water and incident cognitive impairment in chronic hemodialysis patients

Segmental bioelectrical impedance analysis for Korean older population with cold pattern

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