Advertisement

The journal of nutrition, health & aging

, Volume 23, Issue 1, pp 96–101 | Cite as

Total Body Water and Intracellular Water Relationships with Muscle Strength, Frailty and Functional Performance in an Elderly Population. A Cross-Sectional Study

  • Mateu Serra-Prat
  • I. Lorenzo
  • E. Palomera
  • S. Ramírez
  • J. C. Yébenes
Article

Abstract

Background

As a person ages, total body water (TBW), intracellular water (ICW), muscle mass and muscle strength tend to decline. The decline in ICW may reflect losses in the number of muscle cells but may also be responsible for less hydrated muscle cells.

Aim

To assess whether TBW and ICW are associated with muscle strength, functional performance and frailty in an aged population, independently of muscle mass.

Methodology: Design

An observational cross-sectional study of community-dwelling individuals aged 75 years and older. TBW, ICW, fat mass, lean mass and muscle mass were assessed by bioelectrical impedance analysis, frailty status was measured according to Fried criteria, handgrip strength was measured using the hand-held JAMAR dynamometer, and functional performance was measured according to the Barthel index and gait speed.

Results

A total of 324 subjects were recruited (mean age 80.1 years, 47.5% women). TBW and ICW were closely correlated with muscle mass in both sexes. ICW was also associated with Barthel score, gait speed and frailty in both sexes and with handgrip in men. Considerable variability in ICW was observed for the same muscle mass. Multivariate analysis showed a positive effect of ICW on handgrip, functional performance and gait speed and a protective effect of ICW on frailty, independently of age, sex, body mass index and number of comorbidities.

Conclusions

In elderly individuals with similar muscle mass, those with higher ICW had a better functional performance and a lower frailty risk, suggesting a protective effect of cell hydration, independently of muscle mass.

Key words

Total body water intracellular water ageing muscle mass muscle strength frailty functional performance 

References

  1. 1.
    EFSA Panel on dietetic products nutrition and allergies (NDA). Scientific opinion on dietary reference values for water. EFSA journal 2010;8 (3):1459–507.Google Scholar
  2. 2.
    Roumelioti ME, Glew RH, Khitan ZJ, Rondon–Berrios H, Argyropoulos CP, Malhota D, et al. Fluid balance concepts in medicine:principles and practice. World J Nephrol 2018;7 (1):1–28.CrossRefGoogle Scholar
  3. 3.
    Kleiner S. Water:an essential but overlooked nutrient. J Am Diet Assoc 1999;99(2):200–6.CrossRefGoogle Scholar
  4. 4.
    Hooper L, Bunn D, Jimoh FO, Fairweather–Tait SJ. Water–loss dehydration and aging. Mech Ageing Dev 2014;136–137:50–8.CrossRefGoogle Scholar
  5. 5.
    Miller HJ. Dehydration in the Older Adult. J GerontolNurs. 2015;41(9):8–13.Google Scholar
  6. 6.
    Yamada Y, Yoshida T, Yocoyama K, Watanabe Y, Miyake M, Yamagata E, et al. The extracellular to intracellular water ratio in upper legs is negatively associated with skeletal muscle strength and gait speed in older people. J GerontolABiol Sci Med Sci 2017;72:293–8.Google Scholar
  7. 7.
    Serra–Prat M, Papiol M, Vico J, Palomera E, Bartolomé M, Burdoy E. Factors associated with poor muscle mass and strength in a community–dwelling elderly population:a cross–sectional study. J GerontolGeriatr Res 2017;6:2.Google Scholar
  8. 8.
    Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA. Frailty in older adults:evidence for a phenotype. The Journals of Gerontology series A Biological Sciences and Medical Sciences 2001;56A:M146–56.CrossRefGoogle Scholar
  9. 9.
    Morley J, Malmstrom T. Frailty, sarcopenia and hormones. EndocrinolMetabClin N Am 42 (2013) 391–405.CrossRefGoogle Scholar
  10. 10.
    Barzilay JI, Cotsonis GA, Walston J, and the Health ABC study. Insulin resistance is associated with decreased quadriceps muscle strength in nondiabetic adults aged ≥70 years. Diabetes Care 2009;32:736–8.CrossRefGoogle Scholar
  11. 11.
    Fougère B, Boulanger E, Nourhashémi F, Guyonnet S, Cesari M. Chronic Inflammation:Accelerator of Biological Aging. J GerontolABiol Sci Med Sci. 2016. pii:glw240. doi:10.1093/gerona/glw240.Google Scholar
  12. 12.
    Cruz–Jentoft A, Landi F, Topinková E et al. Understanding sarcopenia as a geriatric syndrome. CurrOpin Clin NutrMetab Care 2010;13:1–7.CrossRefGoogle Scholar
  13. 13.
    Kenney WL, Chiu P. Influence of age in thirst and fluid intake. Medicine and Science in sports and exercise 2001:33 (9):1524–32.Google Scholar
  14. 14.
    Carrión S, Roca M, Arreola V, Ortega O, Palomera E, Serra–Prat M, Cabré M, Clavé P. Nutrition status of older patients with oropharyngealdysphagia in a chronic versus an acute clinical situation. Clinical Nutrition 2016.Google Scholar
  15. 15.
    Bennett J. Dehydration:Hazards and benefits. Geriatric Nursing 2000;21:84–88.CrossRefGoogle Scholar
  16. 16.
    Hatakenaka M, Ueda M, Ishigami K, Otsuka M, Masuda K. Effects of ageing on muscle T2relaxation time:difference between fast–and slow–twitch muscles. Invest Radiol 2001;36:692–8.CrossRefGoogle Scholar
  17. 17.
    Ritz P, Investigators of the Source Study and of the Human Nutrition Research Centre–Auvergne. Chronic cellular dehydration and the aged patient. J GerontolABiol Sci Med Sci 2001, 56:M349–M352.CrossRefGoogle Scholar
  18. 18.
    Silva AM, Matias CN, Santos DA, Rocha PM, Minderico CS, Sardinha LB. Increases in intracellular water explain strength and power improvements over a season. Int J Sports Med. 2014 Dec;35(13):1101–5. doi:10.1055/s–0034–1371839. Epub 2014 Jul 10.CrossRefGoogle Scholar
  19. 19.
    Silva A M, Fields D A, Heymsfield S B, Sardinha L B. Body composition and power changes in elite judo athletes. Int J Sports Med 2010;31:737–741CrossRefGoogle Scholar
  20. 20.
    Silva A M, Fields D A, Heymsfield S B, Sardinha L B. Relationship between changes in total–body water and fluid distribution with maximal forearm strength in elite judo athletes. J Strength Cond Res 2011;25:2488–2495CrossRefGoogle Scholar
  21. 21.
    Lang F, Busch G L, Ritter M, Volkl H, Waldegger S, Gulbins E, Haussinger D. Functional significance of cell volume regulatory mechanisms. Physiol Rev 1998;78:247–306CrossRefGoogle Scholar
  22. 22.
    Haussinger D, Roth E, Lang F, Gerok W. Cellular hydration state:an important determinant of protein catabolism in health and disease. Lancet 1993;341:1330–2.CrossRefGoogle Scholar
  23. 23.
    Keller U, Szinnai G, Bilz S, Berneis K. Effects of changes in hydration onprotein, glucose and lipid metabolism in man: impact on health. Eur J Clin Nutr 2003; 57 (suppl 2): s69–s74.CrossRefGoogle Scholar
  24. 24.
    McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G; ASPEN Board of Directors; American College of Critical Care Medicine; Society of Critical Care Medicine. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN J Parenter Enteral Nutr 2009;33(3):277–316.CrossRefGoogle Scholar
  25. 25.
    Singer P, Berger MM, Van den Berghe G, Biolo G, Calder P, Forbes A, Griffiths R, Kreyman G, Leverve X, Pichard C, ESPEN. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr. 2009 Aug;28(4):387–400. doi: 10.1016/j. clnu.2009.04.024. Epub 2009 Jun 7.CrossRefGoogle Scholar
  26. 26.
    Sheean PM, Peterson SJ, Gomez Perez S, Troy KL, Patel A, Sclamberg JS, Ajanaku FC, Braunschweig CA. The prevalence of sarcopenia in patients with respiratory failure classified as normally nourished using computed tomography and subjective global assessment. JPEN J Parenter Enteral Nutr. 2014 Sep;38(7):873–9. doi: 10.1177/0148607113500308. Epub 2013 Aug 26.CrossRefGoogle Scholar
  27. 27.
    Lee Y, Kwon O, Shin CS, Lee SM. Use of bioelectrical impedance analysis for the assessment of nutritional status in critically ill patients. Clin Nutr Res. 2015 Jan;4(1):32–40. doi: 10.7762/cnr.2015.4.1.32. Epub 2015 Jan 23.CrossRefGoogle Scholar
  28. 28.
    Plank LD, Hill GL. Similarity of changes in body composition in intensive care patients following severe sepsis or major blunt injury. Ann N Y Acad Sci. 2000 May;904:592–602.Google Scholar
  29. 29.
    Malbrain ML, Huygh J, Dabrowski W, De Waele JJ, Staelens A, Wauters J. The use of bio–electrical impedance analysis (BIA) to guide fluid management, resuscitation and deresuscitation in critically ill patients: a bench–to–bedside review. Anaesthesiol Intensive Ther. 2014;46(5):381–91.CrossRefGoogle Scholar
  30. 30.
    Finn PJ, Plank LD, Clark MA, Connolly AB, Hill GL. Progressive cellular dehydration and proteolysis in critically ill patients. Lancet 1996;347(9002):654–6.CrossRefGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Mateu Serra-Prat
    • 1
    • 4
  • I. Lorenzo
    • 1
  • E. Palomera
    • 1
  • S. Ramírez
    • 2
  • J. C. Yébenes
    • 3
  1. 1.Research UnitConsorci Sanitari del MaresmeBarcelonaSpain
  2. 2.Primary care centre “Cirera Molins”Consorci Sanitari del MaresmeBarcelonaSpain
  3. 3.Intensive Care UnitConsorci Sanitari del MaresmeBarcelonaSpain
  4. 4.Research UnitHospital of MataróMataró, BarcelonaSpain

Personalised recommendations