Narrative Review of Low-Intake Dehydration in Older Adults

Abstract

Low-intake dehydration is a common and often chronic condition in older adults. Adverse health outcomes associated with low-intake dehydration in older adults include poorer cognitive performance, reduced quality of life, worsened course of illness and recovery, and a high number of unplanned hospital admissions and increased mortality. The subjective methods to assess (risk of) dehydration are not reliable, and the evidence about preventive measures are also limited. So is the knowledge about the optimal intake of beverages per day. This narrative review presents the state of the science on the role of low intake hydration in older adults. Despite its simple cause-the inadequate intake of beverages-low-intake dehydration appears to be a very complex problem to address and much more research is needed in the area. Based on the existing evidence, it seems necessary to take setting specific differences and individual problems and needs into account to tackle dehydration in older adults. Further, it is necessary to increase awareness of the prevalence and severity of low-intake dehydration among older adults and in nursing staff in care homes and hospitals as well as among caregivers of older adults living at home.

Keywords: drinks; hydration; interventions; osmolality; osmolarity.

Figure 1

Flow chart of the identification of new studies according to each research question. ¹ Six different searches were conducted in total (three searches for research question (RQ). RQ1: How should low-intake dehydration be identified in older persons? 1.1 by osmolality, 1.2 by osmolarity, 1.3 by clinical signs and bioelectrical impedance. RQ2: What interventions may help to support older persons to drink well and prevent low-intake dehydration? RQ3: How much should older people drink each day? RQ4: What should older people drink each day?