Notice To Seniors
Stay Hydrated -
Remember To Drink Water

By Janet Mentes, PhD, APRN, BC,
Adapted from the article, "Oral Hydration in Older Adults,"

Serious problems can develop for senior citizens that become dehydrated, including higher risk of coronary heart disease. Age-related changes make older adults more vulnerable to shifts in water balance that can result in dehydration. Greater awareness is needed in preventing, recognizing and treating dehydration.

According to the author, Janet Mentes, PhD, APRN, BC, studies have found

• 31 percent of long-term care residents are dehydrated.
• 48 percent of older adults admitted to the hospital from Emergency Departments have laboratory values indicative of dehydration.
• With sufficient fluid consumption, older people tend to have fewer falls, less constipation and laxative use, improved rehabilitation in orthopedic patients and a reduction in bladder cancer (among men).
• Drinking five or more 8-oz. glasses of water a day is also associated with lower rates of fatal coronary heart disease in middle-age and older adults.

Dehydration is a serious condition that leads to severe consequences if not identified and treated. Unfortunately, the body's thirst response, which is the body’s primary mechanism for signaling the need for fluid, becomes blunted with age and as a result, it is possible for seniors to become seriously dehydrated without even feeling thirsty.

This was apparent in a 2002 trial that compared men 51 to 60 years of age with those 20 to 28 years of age. During a strenuous 10-day hill-walking excursion, the older men had less thirst and became progressively dehydrated; younger participants had no dehydration.

Dehydration in the elderly is not just caused by inadequate fluid intake. Other causes include diarrhea, excessive sweating, blood loss, fluid accumulation and fever. Illnesses that entail excessive urination, such as diabetes and hypercalcemia, may also put people at risk for dehydration.

With aging, it becomes more difficult for the body to maintain fluid balance for an assortment of reasons, says Mentes.

Another study found that in older men, the serum markers of dehydration (serum osmolality and sodium level) took longer to return to normal after dehydration than they did in younger men.

Total Body Fluid
From puberty to 39 years of age, total body fluid is about 60% of body weight in men and 52% in women; after age 60, total body fluid decreases to about 52% of body weight in men and 46% in women. Women have a higher percentage of body fat and less muscle mass than men do and therefore less total body fluid.

In addition, muscle mass is lost with age, increasing the proportion of fat cells, which contain less water than muscle cells do, resulting in a decrease in intracellular fluid volume.

Important Tips:

• Don’t wait until you feel thirsty to get a drink. By the time you feel thirsty, you have already lost two, or more, cups of body fluid.
• Make a habit of drinking fluids periodically throughout the day. It should become an important part of your daily routine. Convenience is essential, so carry beverages with you as you commute to work, run errands, or enjoy the day.
• Drink an additional glass of water for each glass of caffeinated, sweetened, or alcoholic beverage you consume. Caffeinated, sweetened & alcoholic beverages act as diuretics and can actually cause you to lose fluid.
• Keep a beverage on your desk or kitchen counter as a reminder that you need to drink periodically throughout the day.
• Do not underestimate the amount of fluids lost from perspiration, even during the cooler months.
• Start and end your day with a beverage. You lose water even while you sleep. Drink a glass of fluid before going to bed and again when you wake up.
• Do not forget that common illnesses such as colds and the flu can increase the loss of body fluids, and the possibility of dehydration. Keep something to drink next to your bed so you can sip it without getting up.
• On hot days, keep hydrated by drinking cool fluids. Cool fluids are absorbed much more quickly than warm fluids and they will also help to cool you off quickly.