1 in 4 Non-hospitalised Older People are Dehydrated
Why is dehydration a concern?
Low-intake dehydration, which is caused by people not drinking enough, has been linked with lots of health problems, including headaches, falls, dizziness, kidney problems, memory problems, pressure sores and diabetes. Low-intake dehydration increases someone’s risk of going into hospital, and if someone is dehydrated on admission to hospital, they are likely to have worse outcomes, including a longer hospital stay and increased risk of dying.
Dehydration cannot be accurately assessed in older adults using common signs and symptoms, such as checking skin turgor, urine colour, dry mouth, or asking if someone is thirsty. The only robust measure to assess dehydration in older people is directly-measured serum or plasma osmolality, which requires a blood test.
Our 5 main findings:
We have just published our research findings in the Journal of Clinical Nutrition, and we found the following:
- 1 in 4 people aged over 65, either living at home, nursing homes or care homes, were dehydrated from not drinking enough.
- 77% of over-65s do not drink at least 1.5L (roughly 2.5 pints) in a day.
- Older people with more pre-existing illnesses (diabetes, renal and cognitive impairment) were more likely to be dehydrated, than those with fewer illnesses (37% vs 15%).
- Long-term care residents were slightly more at-risk of dehydration than older people living at home, though this was not statistically significant (34 vs 19%).
- Older people with renal impairment were slightly more at-risk of dehydration than those with no kidney problems, though this was not statistically significant (42% vs 23%).
How did we carry out this research?
We decided to carry out a systematic review and meta-analysis, which is a method used to gather and synthesise hydration data from relevant studies around the world, in order to find out how many people are dehydrated, from not drinking enough.
I led a team of seven dedicated and hard-working reviewers to complete this research. After searching five electronic databases for relevant articles from around the world, we found 61 studies from 12 countries. We included studies if they involved people aged 65 years and over, living at home or in long-term care settings, and reported hydration status using directly-measured serum or plasma osmolality (gold standard measure), calculated serum or plasma osmolarity and/or 24-hour oral fluid intake.
Forty-four of these studies had numerical data available which we could use within the meta-analysis, a statistical test.
From this meta-analysis, we found that 24% of older people are dehydrated.
What will we now do with this research?
From this systematic review, we found that dehydration is really common, but can also be prevented from happening. We need to help older adults become more aware of the risk of dehydration and promote healthy drinking habits so that older adults drink enough fluids to prevent dehydration.
I was successful in being awarded some money from the University of East Anglia Impact fund, to co-design posters with older people and health professionals. The posters visualise the ‘1 in 4 dehydration risk’, informing people of the risks of dehydration and encouraging them to drink at least 2L, 3.5 pints, of drinks a day. The posters are being posted to almost 400 GP surgeries, hospitals, nursing homes and care homes across Norfolk & Waveney, in the East of England, to raise awareness of the high risk of dehydration to older people, to the general public, and health and social care professionals. I have also contacted NHS Digital about displaying the posters on digital screens at NHS sites across the UK.
More information?
You can read the full publication here: Low-intake dehydration prevalence in non-hospitalised older adults: Systematic review and meta-analysis – Clinical Nutrition (clinicalnutritionjournal.com)
If you would like more information about this research, or would like digital copies of the dehydration posters, please either contact Ellice on [email protected] or visit: Improving drinking for people living with dementia in care homes – About (uea.ac.uk)
Ellice Parkinson, Research Associate and PhD researcher, School of Health Sciences, University of East Anglia
