Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people

Hooper, Lee; Abdelhamid, Asmaa; Attreed, Natalie J; Campbell, Wayne W.; Channell, Adam M.; Chassagne, Philippe; Culp, Kennith; Fletcher, Stephen J.; Fortes, Matthew B.; Fuller, N. J.; Gaspar, Phyllis; Gilbert, Daniel; Heathcote, Adam Charles; Kafri, Mohannad W.; Kajii, Fumiko; Lindner, Gregor; Mack, Gary W.; Mentes, Janet C.; Merlani, Paolo; Needham, Rowan A.; Rikkert, Marcel G M Olde; Perren, Andréas; Powers, James S.; Ranson, Sheila C.; Ritz, Patrick; Rowat, Anne M; Sjöstrand, Fredrik; Smith, Alexandra C.; Stookey, Jodi; Stotts, Nancy A.; Thomas, David; Vivanti, Angela; Wakefield, Bonnie J.; Waldréus, Nana; Walsh, Neil P.; Ward, S. A.; Potter, John F.; Hunter, Paul R.

doi:10.1002/14651858.cd009647.pub2

Cited by 124 publications

(161 citation statements)

References 168 publications

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…The adjustment of serum osmolality in geriatric patients may be regarded as a rather long-term process. This leads to the question whether serum osmolality is actually the best reference standard for measuring dehydration and whether the used cut-offs are truly useful for clinical decision-making [3]. The question is whether increased serum osmolality should automatically lead to increased fluid intake in geriatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…Due to physiological changes associated with aging (e.g., decreased thirst responses, changes in renal function, altered vasopressin levels, polypharmacy, diuretics, decreased cognitive function) older persons have an increased risk of dehydration. Especially in geriatric patients, water-loss dehydration is associated with poor health outcomes, including falls, fractures, constipation, confusion, drug toxicity, and death [3]. Available studies especially suggest a relationship between hydration status and cognitive performance [4, 5].…”

Section: Introductionmentioning

confidence: 99%

“…However, in clinical practice identifying geriatric patients at risk or with (early) signs of dehydration is challenging. Various clinical tests and methods have been proposed to diagnose dehydration (e.g., “skin turgor test,” expressing fatigue, missing drinks between meals, dry mouth, and tongue furrows), but a recent Cochrane review indicated that the evidence supporting the diagnostic accuracy of these tests is extremely weak [3]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

Akdeniz

Boeing

Müller‐Werdan

et al. 2018

Skin Pharmacol Physiol

View full text Add to dashboard Cite

Background/Aim: Inadequate fluid intake is assumed to be a trigger of water-loss dehydration, which is a major health risk in aged and geriatric populations. Thus, there is a need to search for easy to use diagnostic tests to identify dehydration. Our overall aim was to investigate whether skin barrier parameters could be used for predicting fluid intake and/or hydration status in geriatric patients. Methods: An explorative observational comparative study was conducted in a geriatric hospital including patients aged 65 years and older. We measured 3-day fluid intake, skin barrier parameters, Overall Dry Skin Score, serum osmolality, cognitive and functional health, and medications. Results: Forty patients were included (mean age 78.45 years and 65% women) with a mean fluid intake of 1,747 mL/day. 20% of the patients were dehydrated and 22.5% had an impending dehydration according to serum osmolality. Multivariate analysis suggested that skin surface pH and epidermal hydration at the face were associated with fluid intake. Serum osmolality was associated with epidermal hydration at the leg and skin surface pH at the face. Fluid intake was not correlated with serum osmolality. Diuretics were associated with high serum osmolality. Conclusions: Approximately half of the patients were diagnosed as being dehydrated according to osmolality, which is the current reference standard. However, there was no association with fluid intake, questioning the clinical relevance of this measure. Results indicate that single skin barrier parameters are poor markers for fluid intake or osmolality. Epidermal hydration might play a role but most probably in combination with other tests.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

Akdeniz

Boeing

Müller‐Werdan

et al. 2018

Skin Pharmacol Physiol

View full text Add to dashboard Cite

show abstract

“…The signs of dehydration are seen earlier than malnutrition; common symptoms include increasing heart rate, diminished urine output, nausea, dry lips, spasm, unexplained mental confusion [17] and, sometimes, pale mucosa [18].…”

Section: Symptoms Of Malnutrition and Dehydrationmentioning

confidence: 99%

Nutrition and Hydration

Roigk

2018

Perspectives in Nursing Management and Care for Older Adults

View full text Add to dashboard Cite

Malnutrition and dehydration are important aspects of the care of older people, particularly those in hospitals or in long-term care facilities. Many older people do not eat and drink adequately during hospital stays and, following hip fracture, many patients achieve only a half of their recommended daily energy, protein and other nutritional requirements [1]. This leads to poor recovery and diminished health status and functional ability and results in a higher risk of other complications (Chap. 6).Nurses are the coordinators of the care process, so it is essential that they bring other health-care specialists together as a team to collaboratively provide highquality care that reflects patients' needs for assessment, intervention and health promotion. When an interdisciplinary team (orthogeriatric collaboration) work together care is more successful, improves patient outcomes and reduces the risk of the inhospital and long-term mortality.The aim of this chapter is to increase awareness of nurses' responsibility, within a multidisciplinary team, for assessment and intervention of nutrition and hydration, examine the issues pertaining to nutrition and fluid balance in older people and outline the nature, assessment and interventions relating to malnutrition and dehydration. Learning OutcomesAt the end of the chapter, and following further study, the nurse will be able to:

show abstract

“…A paucity of trial evidence exists for managing poor hydration in acute stroke and furthermore, identifying hypovolaemia with standard signs and symptoms has poor diagnostic correlations. 9 In contrast, stronger evidence exists for dysphagia screening. 10 Acute ischaemic stroke…”

Section: General Managementmentioning

confidence: 99%

Latest Developments in Clinical Stroke Care

Minhas

Robinson

2017

Journal of the Royal College of Physicians of Edinburgh

View full text Add to dashboard Cite

Stroke medicine has seen rapid developments in diagnosis and management, and consequently improved prognosis. Management of ischaemic stroke, in particular, has benefited from these advances. The approach to management has evolved from one of historical passivity to active intervention with time of the essence following stroke onset. The last decade has seen the comparative effectiveness of several pharmacological agents being tested, creating significant randomised controlled trial evidence to support the management of common clinical problems following acute stroke. While several of these interventions are widely available, some remain less accessible. This review will discuss the latest developments in clinical stroke medicine, based on a symposium presentation at the Royal College of Physicians of Edinburgh, and reference key randomised controlled trial evidence in an effort to provide a balanced perspective on our current understanding of acute ischaemic and haemorrhagic stroke.

show abstract

Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people

Cited by 124 publications

References 168 publications

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study

Nutrition and Hydration

Latest Developments in Clinical Stroke Care

Contact Info

Product

Resources

About