Abstract
Objective
Translate the available knowledge on ageing and dehydration into main messages for clinical practice.
Main points
Older people are more susceptible to dehydration than younger people. This is partly due to lack of thirst sensation and changes in the water and sodium balance that naturally occur as people age. It is also, to some degree, attributable to the fact that elderly people, both those living at home and those living in institutions, often have various impairments, disabilities and/or handicaps (comorbidity). They also tend to use numerous drugs and medication for these illnesses (polypharmacy). Multimorbidity and polypharmacy often overstress the normal age-related physiological changes in the water and sodium balance and therefore increase elderly people’s risk of dehydration,especially during intercurrent infections or warm weather. Elderly people, whether they are living on their own or in an institution, and especially elderly people that can no longer take care of themselves because of cognitive, sensory, motor and/or ADL impairments, need extra help to stay hydrated. The most important strategy is simply a matter of ensuring that elderly people consume a sufficient amount of fluids (at least 1.7 liters every 24 hours). Additional strategies include making healthy drinks and water easily available and accessible at all times and reminding and encouraging the elderly to consume these fluids. Elderly people should not be encouraged to consume large amounts of fluids at once but rather small amounts throughout the day. When the recommended fluid intake cannot, for whatever reason, be realized, fluids can be administered via catheter or by hypodermoclysis. In more specific and severe cases, fluids can be administered intravenously.
Conclusion
The prevention, signaling and treatment of dehydration in the elderly is an important multidisciplinary endeavor. Formal and informal care providers need to continuously be aware of the risk factors and signs of dehydration in the elderly, especially during periods of very warm weather and when older people are ill. Standard professional care for high risk patients is imperative.
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References
Ferry M. Strategies for ensuring good hydration in the elderly. Nutr Rev 2005;63(6):S22–S29.
Wilson MG. Dehydration. In: Pathy MSJ, Sinclair AJ, Morley JE eds.. Principles and Practice of Geriatric Medicine 4th ed. England: John Wiley & Sons Ltd,; 2006:321–328.
Gaspar PM. Water intake of nursing home residents. J. Gerontol Nurs 1999;25(4):23–29.
Faes MC, Spigt MG, Olde Rikkert MGM. Dehydration in geriatrics. In press, Geriatrics and Aging, 2007.
Lavizzo-Mourey R, Johnson J, Stolley P. Risk factors for dehydration among elderly nursing home residents. J Am Geriatr Soc 1988;36:213–218.
Molaschi M, Ponzetto M, Massaia M et al. Hypernatremic dehydration in the elderly on admission to hospital. J Nutr Health Aging 1997;1(3):156–160.
Schoeller DA. Changes in total body water with age. Am J Clin Nutr 1989;50:1176–1181.
Ayus JC, Arieff Al. Abnormalities of water metabolism in the elderly. Semin Nephrol 1996;16:277–288.
Phillips PA, Rolls BJ, Ledingham JGG, Forsling ML, Morton JJ, Crowe MJ, Wollner L. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med 1984;311(12): 753–759.
Ritz P. Investigators of the Source Study and of the Human Nutrition Research Centre-Auvergne. Chronic cellular dehydration and the aged patient. J Gerontol A Biol Sci Med Sci 2001;56:M349–M352.
Wilson MM. Morley JE. Impaired cognitive function and mental performance in mild dehydration. Eur J Clin Nutr 2003;57:S24–S29.
Embon OM, Rose GA. Rosenbaum T. Chronic dehydration stone disease. Br J Urol 1990;66:357–362.
Wrenn K. Fecal impaction. N Engl J Med 1989;321:658–662.
Gershan JA, Freeman CM, Ross MC et al. Fluid volume deficit; validating the indicators. Heart Lung 1990;19:152–156.
Weinberg AD, Minaker KL. Dehydration: evaluation and management in older adults. JAMA 1995;274:1552–1556.
Olde Rikkert MGM, van’t Hof MA, Baadenhuysen H, Hoefnagels WHL. Individuality and responsiveness of biochemical indices of dehydration in hospitalized elderly patients. Age Ageing 1998;27:311–319.
Lindeman RD, Tobin J, Shock NW. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 1985;33:278–285.
Bastiaanssen WCM, Kroot LAJ. How much fluid do healthy old people use? Hoeveel vocht gebruiken gezonde oude mensen? Tijdschr Gerontol Geriatr 1994;25:197–2004.
Ribbe MW, Ljunggren G, Steel K, Topinková E, Hawes C, Ikegami N, Henrard JC, Jónnson PV. Nursing homes in 10 nations: a comparison between countries and settings. Age Ageing. 1997;26Suppl 2:3–12.
Schols JM, Crebolder HF, van Weel C. Nursing home and nursing home physician: the Dutch experience. J Am Med Dir Assoc. 2004;5(3):207–212.
Chidester JC, Spangler AA. Fluid intake in the institutionalized elderly. J Am Diet Assoc 1997;97:23–28.
Frisoli A, Paula AP de, Feldman D et al. Subcutaneous hydration by hypodermoclysis. A practical and low cost treatment for elderly patients. Drugs Aging 2000;16:313–319.
Sasson M, Shvartzman P. Hypodermoclysis: an alternative infusion technique. Am Fam Physician 2001;64:1575–1578.
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Schols, J.M.G.A., De Groot, C.P.G.M., Van Der Cammen, T.J.M. et al. Preventing and treating dehydration in the elderly during periods of illness and warm weather. J Nutr Health Aging 13, 150–157 (2009). https://doi.org/10.1007/s12603-009-0023-z
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DOI: https://doi.org/10.1007/s12603-009-0023-z