Importance Of Hydration: Water is the medium in which all chemical reactions in the body take place, and as we age, the total body water content decreases as there is less lean body mass (muscle) and a higher percentage of body fat (low-fat tissue). of water). It is estimated that the total body water content can be reduced by four to six liters from the age of 20 to 80 years.
Water is one of the main nutrients of the organism, a major component of the human body, involved in numerous functions of the organism, and essential in all stages of life. As we age, the mechanisms responsible for water balance can be altered. which is why there is a greater risk of dehydration.
What Is Dehydration?
Dehydration is the reduction in total body water content due to fluid loss, decreased fluid intake, or a combination of both. In addition, according to the EFSA (European Food Safety Authority), it can be of three types:
- Isotonic dehydration: as much water as sodium is lost, for example in the case of diarrhea.
- Hypertonic dehydration: a greater loss of water than sodium occurs, for example, in the case of a fever.
- Hypotonic dehydration: greater loss of sodium than water, for example, in the case of excessive use of diuretics.
Changes In Physiology Due To Age That Influence Fluid Balance
Total Body Water Content
As we age, the total body water content is reduced as there is a lower lean body mass (muscle) and a higher percentage of body fat (tissue with low water content). It is estimated that the total body water content can be reduced by four to six liters from the age of 20 to 80 years (Gille 2010). Therefore, small losses of body water or not drinking enough can more easily cause dehydration.
The feeling of thirst tends to decrease in older people, which may imply less fluid consumption. It is not known exactly what can cause the decrease in the sensation of thirst, although it is believed that it may be due to a reduction in dopamine. a neurotransmitter that participates in the induction of thirst and the increase in plasma ANP (atrial natriuretic peptide) a thirst quencher. Due to this worse regulation of thirst, older people often do not drink enough and do not usually hydrate properly.
The very deterioration of the kidney’s ability to conserve water is a consequence of aging. The kidneys are less able to concentrate urine and retain water when necessary. In addition, there is a lower response of the kidneys against the anti-diuretic hormone (ADH) and a limitation in the excretory capacity of the kidneys.
Aging can lead to limitations such as reduced swallowing ability, reduced mobility or comprehension, and communication disorders that can lead to insufficient fluid intake, as well as diseases or symptoms, such as diabetes or urinary incontinence that can increase losses. of water. Environmental factors such as high temperatures, humidity… or medication can increase the risks of possible dehydration.
Dehydration symptoms are organized by severity: mild or moderate, and severe:
- Mild or moderate dehydration: thirst, muscle cramps, headache, lack of elasticity in the skin, little urine, drowsiness, and tiredness.
- Severe dehydration: not urinating, rapid breathing, dry and wrinkled skin, confusion, dizziness, increased heart rate, and sunken eyes.
- Very serious: insufficient blood flow, hallucinations, and unconsciousness.
Consequences Of Dehydration In The Elderly
Current evidence suggests that dehydration can cause:
- Constipation(it is the main consequence of dehydration).
- Alteration of cognitive functions.
- Postural hypotension (a form of low blood pressure that occurs when you stand up from sitting or lying down).
- Dysfunction of the salivary glands (low production of saliva).
- Poor control of hyperglycemia in diabetes.
- Urinary infection.
- Kidney stones.
The prevention of dehydration in the elderly is mainly based on guaranteeing a correct fluid intake. The awareness of the elderly, their families, and their caregivers regarding the severity of dehydration and its risk factors is essential. It is important to adapt to the elderly, considering individual risks (medication, incontinence…) and environmental (humidity, temperature…) to achieve optimal hydration.
Fluid Intake Recommendations For The Elderly
Daily water needs depend on several factors, such as fluid losses, and diet composition. environmental temperature, taking medication or certain pathologies, etc. That is why many countries do not give a national recommendation on water intake, or there is a lot of variation from one country to another. In Europe, the European Food Safety Authority recommends that the reference value for total fluid intake (water from drinks and food) be 2.5 l and 2 l for older men and women. respectively. So those elderly people who find it difficult to drink water should have a diet especially rich in fruits and vegetables.
Strategies To Encourage Fluid Intake
- Offer fluids regularly throughout the day
- Place liquids near, next to the bed, or next to the chair of the elderly in geriatric centers, throughout the day.
- Offer it comfortably, with a glass, bottle, or straw… depending on the needs.
- Encourage fluid intake with medication.
- Offer drinks that the person likes especially if they are healthy.
- Guarantee a minimum intake of 1.5 liters in periods of greatest risk of dehydration.
What Kind Of Liquids And Food Can Be Offered?
In addition to drinking water as the main drink, fruits, vegetables, and vegetables should be part of the daily diet. Other valid options to hydrate are: consuming broths, non-salty soups, and milk, but always take into account the thermal and humidity conditions, offering more water at higher figures. Coffee and tea can have a diuretic effect, so they should be consumed in moderation and not as a main drink. It is not recommended to drink alcoholic beverages.
The degree of hydration of the elderly is the result of a fragile balance; therefore, it must be controlled in great detail. Constant attention must be paid, as dehydration can cause considerable clinical consequences.
What you should know…
- Water is the medium in which all the chemical reactions of the body take place, it acts as a carrier of nutrients and as a vehicle to eliminate waste products, it lubricates and provides structural support to tissues and joints, and it has a fundamental role in the regulation of body temperature, essential to avoid dehydration.
- As we age, the total body water content is reduced as there is less lean body mass (muscle) and a higher percentage of body fat (tissue with low water content). It is estimated that the total body water content can be reduced by four to six liters from the age of 20 to 80 years.
- In addition to drinking water as the main drink, fruits, vegetables, and vegetables should be part of the daily diet. Other valid options to hydrate are to consume broths, non-salty soups, and milk.