title: Hydration and independence in activities of daily living in people with multiple sclerosis: a pilot investigation.
abstract: OBJECTIVE
  Bladder dysfunction and disability may cause people with multiple sclerosis (pwMS) to limit fluid intake. However, hydration is rarely considered in the multiple sclerosis literature. We investigated the hydration status of people with pwMS and its association with independence in activities of daily living.
  
  
  METHODS
  Twenty-six (six men) pwMS over 18 years old and able to walk with or without an aid took part in the study. Hydration status was measured via urine osmolality, with adequate hydration defined as an osmolality ≤500 (mOsm kg(-1)). Independence in daily activities was measured using the Barthel index.
  
  
  RESULTS
  Mean urine osmolality was 470 ± 209 mOsm kg(-1) and indicated 11 (42%) participants were not adequately hydrated. Independence in daily activities could partly explain hydration status (R(2) = 0.209, p < 0.05). Additionally there was a trend for men to be less well hydrated than women.
  
  
  CONCLUSIONS
  The results indicate that some pwMS were not adequately hydrated and that this could be partly explained by disability. Implications of reducing and maintaining fluid levels on function and quality of life in relation to bladder dysfunction and disability in pwMS should be investigated.
authors.affiliation: Movement Science Group, Oxford Brookes University, Oxford OX3 0BP, UK. jcollett@brookes.ac.uk
authors.forename: Johnny
authors.initials: J
authors.lastname: Collett
authors.forename: Helen
authors.initials: H
authors.lastname: Dawes
authors.forename: Ana
authors.initials: A
authors.lastname: Cavey
authors.forename: Andy
authors.initials: A
authors.lastname: Meaney
authors.forename: Catherine
authors.initials: C
authors.lastname: Sackley
authors.forename: Derick
authors.initials: D
authors.lastname: Wade
authors.forename: Ken
authors.initials: K
authors.lastname: Howells
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001834:Body Water / Q000737:chemistry* / Q000378:metabolism; D003681:Dehydration / Q000503:physiopathology / Q000652:urine*; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D009994:Osmolar Concentration; D010865:Pilot Projects; D011788:Quality of Life; D012044:Regression Analysis; D014556:Urine / Q000737:chemistry / Q000502:physiology