June 6, 2013

Health Minute With CASI – Dehydration – A Senior Health Risk

By Michelle Migliore, RN

It’s important for seniors to be more aware of ways to prevent dehydration, recognize its signs, and treat it promptly. Sudden shifts in the body’s water balance can frequently result in dehydration, and the physical changes associated with aging expose our seniors in particular to the risks of dehydration. The danger is that they may not know about their dehydrated condition, which could lead to more serious consequences.

Dehydration is often due partly to inadequate water intake, but can happen for many other reasons as well, including as a side effect of prescribed medication like diuretics, diarrhea, excessive sweating, loss of blood and diseases such as diabetes. Aging itself makes people less aware of thirst and also gradually lowers the body’s ability to regulate its fluid balance:

Scientists state that the ability to be aware of and respond to thirst is slowly blunted as we age. As a result, older people do not feel thirst as readily as younger people do. This increases the chances of them consuming less water and consequently suffering dehydration.

The body loses water as we age. Until about age 40, the proportion of total body fluids to body weight is about 60 percent in men and 52 percent in women (the gender difference is due to greater muscle mass and lower body fat in men compared to women; muscle cells contain more water than fat cells). After age 60, the proportion goes down to 52 percent in men and 46 percent in women. The reason for the decline is the loss of muscle mass as one ages and a corresponding increase in fat cells.

In addition, the kidneys’ ability to remove toxins from the blood progressively declines with age. This means the kidneys are not as efficient in concentrating urine in less water, thus older people lose more water than younger ones.

If dehydration is not identified and treated, the consequences to health are significant, including reduced or even loss of consciousness, rapid but weak pulse, and lowered blood pressure. If rehydration is not started, the situation can become life-threatening.

Seniors and Caregivers should watch for these signs of dehydration:

Mild dehydration:
• Dryness of mouth; dry tongue with thick saliva
• Unable to urinate or pass only small amounts of urine
• Dark or deep yellow urine
• Cramping in limbs
• Headaches
• Crying but with few or no tears
• Weakness, general feeling of being unwell
• Sleepiness or irritability

More serious dehydration:
• Low blood pressure
• Convulsions
• Severe cramping and muscle contractions in limbs back and stomach
• Bloated stomach
• Rapid but weak pulse
• Dry and sunken eyes with few or no tears
• Wrinkled skin; no elasticity
• Breathing faster than normal

Everyone knows—but many people seem to forget—that water is what sustains life. Older people, who get enough water, tend to suffer less constipation, use less laxatives, have fewer falls and, for men, may have a lower risk of bladder cancer. Less constipation may reduce the risk of colorectal cancer. Drinking at least five 8-ounce glasses of water daily reduces the risk of fatal coronary heart disease among older adults. Seniors should make sure they have water by their side at all times. Encourage frequent drinking in moderate amounts.