Wittbrodt · Medicine and science in sports and exercise 2018 · systematic review and meta-analysis · n=33 studies (413 participants)

Dehydration Impairs Cognitive Performance: A Meta-analysis.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of experimental trials

PubMed 29933347 · doi:10.1249/MSS.0000000000001682 · record verified 2026-08-26

What was done

The authors conducted a systematic literature review and multivariate meta-analysis of 33 studies (providing 280 effect size estimates from 413 subjects) to examine the impact of dehydration (ranging from 1% to 6% body mass loss) across various cognitive domains, outcome measures (accuracy, reaction time), and dehydration induction methods.

What was found

Dehydration resulted in a small but significant overall impairment across all cognitive domains and outcomes (ES = -0.21; 95% CI: -0.31 to -0.11; P < 0.0001) with significant heterogeneity (Q(279) = 696.0, P < 0.0001; I² = 37.6%). Significant impairments were observed in attention (ES = -0.52; 95% CI: -0.66 to -0.37), motor coordination (ES = -0.40; 95% CI: -0.63 to -0.17), and executive function (ES = -0.24; 95% CI: -0.37 to -0.12) (all P ≤ 0.01), which differed from reaction time tasks (ES = -0.10; 95% CI: -0.23 to 0.02; P < 0.001). Impairment increased with greater body mass loss (P = 0.04), showing larger effects for >2% loss (ES = -0.28; 95% CI: -0.41 to -0.16) versus ≤2% loss (ES = -0.14; 95% CI: -0.27 to 0.00).

Why it matters

This review establishes that acute dehydration causes domain-specific cognitive deficits—most prominently affecting attention, motor coordination, and executive function—with impairment escalating significantly when fluid deficits exceed 2% of body mass.

Limits

The total pooled sample was modest (413 participants across 33 trials), reflecting small individual study sizes. Substantial heterogeneity was present across trials due to varying dehydration protocols, cognitive testing batteries, and outcome measures.

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