Dehydration Encephalopathy: A Neurological Emergency in the Older Adults

Sakakibara, Ryuji; Kusumoto, Masahiko; Ogawa, Emina; Tateno, Fuyuki; Ogata, Tsuyoshi; Haruta, Hiroyuki; Mori, Yasuo; Shirai, Kohji

doi:10.1111/j.1532-5415.2010.03055.x

Cited by 6 publications

(10 citation statements)

References 9 publications

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“…There have even been reports of Dehydration Encephalopathy in older adults, associated with decreased functioning of the frontal lobes and diffuse symptoms such as the appearance of cognitive decline [54]. Some have, however, suggested that age does not necessarily result in physiological changes in the kidney, rather decreased renal functioning reflects various disease states, albeit the incidence of many diseases increase with age [55].…”

Section: Discussionmentioning

confidence: 99%

Dehydration Influences Mood and Cognition: A Plausible Hypothesis?

Benton

2011

Nutrients

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The hypothesis was considered that a low fluid intake disrupts cognition and mood. Most research has been carried out on young fit adults, who typically have exercised, often in heat. The results of these studies are inconsistent, preventing any conclusion. Even if the findings had been consistent, confounding variables such as fatigue and increased temperature make it unwise to extrapolate these findings. Thus in young adults there is little evidence that under normal living conditions dehydration disrupts cognition, although this may simply reflect a lack of relevant evidence. There remains the possibility that particular populations are at high risk of dehydration. It is known that renal function declines in many older individuals and thirst mechanisms become less effective. Although there are a few reports that more dehydrated older adults perform cognitive tasks less well, the body of information is limited and there have been little attempt to improve functioning by increasing hydration status. Although children are another potentially vulnerable group that have also been subject to little study, they are the group that has produced the only consistent findings in this area. Four intervention studies have found improved performance in children aged 7 to 9 years. In these studies children, eating and drinking as normal, have been tested on occasions when they have and not have consumed a drink. After a drink both memory and attention have been found to be improved.

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Section: Discussionmentioning

confidence: 99%

Dehydration Influences Mood and Cognition: A Plausible Hypothesis?

Benton

2011

Nutrients

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“…suggesting dehydration on arrival, which were reversed at discharge after saline infusion. 1 The exclusion criteria of DE were i) diffuse CNS diseases such as encephalitis or systemic diseases (hypoxia, hyperglycemic coma, extreme hypertension, etc. ), ii) drug abuse, and iii) focal CNS diseases such as stroke, etc.…”

Section: Methodsmentioning

confidence: 99%

“…), ii) drug abuse, and iii) focal CNS diseases such as stroke, etc. 1 All patients or their families gave informed consent before participating in the study. The present study was approved by the Ethics Committee in Sakura Medical Center, Toho University.…”

Section: Methodsmentioning

confidence: 99%

“…Systemic dehydration and diffuse central nervous system (CNS) signs without any other illness is referred to as dehydration encephalopathy (DE), 1 with disturbed consciousness being the main clinical feature. DE was originally described as a neurologic emergency by physicians in our neurology department.…”

Section: Introductionmentioning

confidence: 99%

“…DE was originally described as a neurologic emergency by physicians in our neurology department. 1 However, the incidence of DE at emergency units has remained uncertain. Herein we investigate the incidence of DE among persons with disturbed consciousness of various etiologies who visited the emergency unit at our university hospital.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Dehydration Encephalopathy among Patients with Disturbed Consciousness at a Hospital Emergency Unit

Ogawa

Sakakibara

Endo

et al. 2011

Clinics and Practice

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Systemic dehydration and diffuse central nervous system signs without any other illness is referred to as dehydration encephalopathy (DE). However, the incidence of DE at emergency units remains uncertain. We investigated the incidence of DE among persons with disturbed consciousness who visited the emergency unit. We reviewed the medical case records of the emergency unit at our university hospital during a 6-month period. Among them, 132 patients presented with disturbed consciousness as the sole initial manifestation on arrival. They were 75 men, 47 women; mean age 68 years (16–95 years). After carefully excluding other etiologies, the incidence of DE was 2% among all persons in the emergency unit and 4% among persons older than 68 years. In conclusion, the incidence of DE in our emergency unit was not common. Nevertheless, recognition of DE is extremely important in order to avoid unnecessary medication in elderly subjects.

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