Abstract
Abnormalities of water homeostasis can be early expressions of neuronal dysfunction, brain atrophy, chronic cerebrovasculopathy and neurodegenerative disease. The aim of this study was to analyze the serum osmolality of subjects with cognitive impairment.The hydromolecular hypothesis intends to explain the relationship between dehydration and cognitive impairment in older patients as the result of protein misfolding and aggregation, in the presence of a low interstitial fluid volume, which is a defect of the microcirculation. Defective proteins were shown to impair the amount of information in brain biomolecular mechanisms, with consequent neuronal and synaptic damage.
Highlights
The regulation of water balance is governed by a feedback mechanism involving the function and interaction of different regions of the central nervous system and the kidneys
The exclusion criteria were as follows: (1) diagnosis of mixed dementia (MxD); (2) presence of a serious comorbidity, tumors, other diseases or physiological status, that could be causally related to cognitive impairment; (3) history of alcohol or drug abuse, head trauma, and other causes that could cause memory impairment
Nine patients were excluded because they were younger than 65 years, 12 patients had an incomplete examination and 23 patients had MxD
Summary
The regulation of water balance is governed by a feedback mechanism involving the function and interaction of different regions of the central nervous system and the kidneys. Vasopressin binds receptors in the kidney that decrease the excretion of water, and subsequently, a greater fraction of filtered water is returned to the blood. This process lowers the plasma osmolality, reduces the stimulus for vasopressin secretion and thirst and completes the feedback loop. Failure of this mechanism, which is commonly observed in hospitalized patients, results in a variety of water balance disorders. Water homeostasis regulation can be altered because of multifactorial mechanisms, such as renal function alterations, body composition and hypothalamic–pituitary regulation of thirst and vasopressin secretion changes
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