Abstract
Elderly patients in long-term care have a high plasma osmolality (pOSM) and associated increased mortality. In these patients, we examined pOSM, thirst (visual analogue scale, VAS) and arginine vasopressin (AVP) response to 16-hour dehydration and 2-hour rehydration. Twelve patients were randomly divided into two groups (A & B). Group A had their fluid balance monitored for two weeks, group B did not. Single measurements of VAS, pOSM and AVP were conducted on days 0, 7 and 13. Dehydration tests were conducted in both groups at the start of the study (DAY 1), and at the end of the two-week period (DAY 14). There were no significant differences between group A and B, so the results are presented for the two groups combined. There was a significant increase in both pOSM and VAS during dehydration, and a significant fall in both variables during rehydration [F (9,99) = 18.69, p<0.001, and F(9,99) = 11.25, p<0.001, respectively]. Plasma AVP did not change significantly during either dehydration or rehydration [F (9,99) = 0.59, p=0.8]. There were no significant differences in response for any of the three variables between DAY 1 and DAY 14. We conclude that elderly patients in long-term care exhibit changes in thirst and osmolality during dehydration and rehydration, and that these responses are reproducible. The lack of a significant AVP response requires further investigation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
O’Neill P.A., Davies I., Wears R., Barrett J.A.: Elderly female patients in continuing care: Why are they hyperosmolar? Gerontology 35: 205–209, 1989.
O’Neill P.A., Farragher E.B., Davies I., Wears R., McLean K.A., Fairweather D.S.: Reduced survival with increasing plasma osmolality in elderly continuing-care patients. Age Ageing 19: 68–71, 1990.
Helderman J.H., Vestal R.E., Rowe J.E., Tobin J.D., Andres R., Robertson J.L.: The response of arginine vasopressin to intravenous ethanol and hypertonic saline in man: The impact of ageing. J. Gerontol. 33: 39–47, 1978.
Faull C.M., Holmes C., Baylis P.H.: Water balance in elderly people: Is there a deficiency of vasopressin? Age Ageing 22: 114–120, 1993.
Phillips P.A., Rolls B.J., Ledingham J.G.G., Forsling M.L., Morton J.J., Crowe M.J., Wollner L.: Reduced thirst after water deprivation in healthy elderly men. N. Eng. J. Med. 311: 753–759, 1984.
Phillips P.A., Bretherton M., Johnston C.E., Gray L.: Reduced osmotic thirst in healthy elderly men. Am. J. Physiol. 261: R166–R171, 1991.
Crowe M.J., Forsling M.L., Rolls B.J., Phillips P.A., Ledingham J.G.G., Smith R.F.: Altered water excretion in healthy elderly men. Age Ageing 16: 285–293, 1987.
Davies I., O’Neill P.A., McLean K.A., Catania J., Bennett D.: Age-associated alterations in thirst and arginine vasopressin in response to a water or sodium load. Age Ageing 24: 151–159, 1995.
Mukerjee A.P., Coni N.K., Davison W.: Osmoreceptor function among the elderly. Geront. Clin. 15: 227–233, 1973.
Cole M.G.: Inter-rater reliability of the Crichton geriatric behavioural rating scale. Age Ageing 18: 57–60, 1989.
Thompson C.J., Bland J., Burd J., Baylis P.H.: The osmotic thresholds for thirst and vasopressin release are similar in healthy man. Clin. Sci. 71: 651–656, 1986.
Kirkland J.L., Pearson D.J., Goddard C., Davies I.: Polyuria and inappropriate secretion of arginine vasopressin in hypothalamic sarcoidosis. J. Clin. Endocrinol. Metab. 56: 269–272, 1983.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
O’Neill, P.A., Duggan, J. & Davies, I. Response to dehydration in elderly patients in long-term care. Aging Clin Exp Res 9, 372–377 (1997). https://doi.org/10.1007/BF03339616
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03339616