Our member, Callie Wight, R.N., offers this advice about hydration as the summer heats up. This information originally appeared in the Idyllwild Town Crier on May 16, 2018.
Dehydration is common and a very serious condition in older adults (64 years and older). Maintaining the body’s fluid balance is critical to healthy aging. Dehydration when not adequately treated can be fatal; it’s associated with serious effects like poor mental functioning, blood clots, infectious diseases, kidney stones, and severe constipation. Dehydration should be prevented whenever possible; properly diagnosed and treated when present.
As we age, there is a decrease in overall body hydration (the absolute amount of water in the body). In addition, kidney function and the sensation of thirst decline in older adults. Taken together, these account for the prevalence of dehydration. (Note: if you are thirsty you are already dehydrated).
With increasing age, a substantial number of older adults drinks less than 1 quart of fluid per day. The lower our body weight and overall body hydration, the sooner the loss of even a small amount of body water will cause dehydration. Environmental and disease-related risk factors play a substantial role among older adults. For instance, even a viral infection with its high fevers, vomiting and diarrhea can dehydrate.
The most important risk factors for dehydration were identified in a large study on a nursing home population: Being over 85 years old, female, having five or more chronic diseases, taking five or more kinds of medication, and being bedridden. Being dependent on others for care, and therefore water intake, can increase the risk of dehydration. Since much fluid is taken with meals, eating “like a bird” may lead to lesser intakes of water than is desirable.
Diagnosing dehydration in the older population isn’t straightforward. Classical signs such as the time it takes skin to rebound when pinched (recoil), increased thirst, and drops in blood pressure upon standing up are not reliable in older adults. At the same time, dehydration often causes symptoms associated with several other conditions in the elderly; symptoms like confusion, constipation, fever or falls. This all muddies the diagnostic waters.
However, good news, we can self-manage. When older adults know that they should not trust to thirst to signal dehydration (if you’re thirsty you’re already dehydrated), but drink water because it is healthy, their intake increases above the absolute minimum intake of 57 ½ fluid ounces of water per day.
For calculating the minimum amount of fluid per day, an easy method is to drink half your body weight in ounces of water daily. Remember, that’s merely a minimum. Be sure to increase intake by many ounces in pregnancy/breastfeeding, hot weather, dry or humid climates, high altitudes and physical activity.
Caffeine leeches water from your body, so avoid it in sodas, coffee and even teas. (Black and green teas both contain caffeine.) Alcoholic drinks as well as fluids with high protein intake also leech body water.
Reminders to yourself, friends, loved ones to drink water plus keeping water visibly handy during the day can help. Don’t underestimate dehydration!