Impending Low Intake Dehydration at Admission to A Geriatric Ward- Prevalence and Correlates in a Cross-Sectional Study

Abstract

Dehydration risk increases with frailty and functional dependency, but a limited number of studies have evaluated this association in hospitalized geriatric patients. This cross-sectional study aimed to assess the prevalence and determinants of dehydration in patients admitted to the geriatric ward. Dehydration was diagnosed when calculated osmolarity was above 295 mMol/L. Logistic regression analyses (direct and stepwise backward) were used to assess determinants of impending dehydration. 358 of 416 hospitalized patients (86.1%) were included: 274 (76.5%) women, and 309 (86.4%) 75+ year-old. Dehydration was diagnosed in 209 (58.4%) cases. Significantly higher odds for impending dehydration were observed only for chronic kidney disease with trends for diabetes and procognitive medication when controlling for several health, biochemical, and nutritional parameters and medications. After adjusting for "dementia" the negative effect of "taking procognitive medications" became a significant one. Chronic kidney disease, diabetes, taking procognitive medications and hypertension were the main variables for the outcome prediction according to the stepwise backward regression analysis. This may indicate an additional benefit of reducing the risk of dehydration when using procognitive drugs in older patients with dementia.

Are older adults with excessive sodium intake at increased risk of hypohydration?

“…Given the well documented relation between kidney disease and hydration, 22 we further tested the association between sodium excretion and hydration status excluding participants with self‐reported renal disease ( n = 123).…”

Distinguishing Low and High Water Consumers—A Paradigm of Disease Risk

“…Similarly, increasing TWI is important for elderly adults who live in geriatric facilities, because dehydration is associated with significant adverse outcomes in older people despite being largely preventable and treatable [121]. For example, two recent European studies published in Nutrients reported that dehydration (P OSM > 295 mOsm•kg −1 ) was observed in 58.4% of 358 individuals (86% > 75 y) [122] and that a S Na+ value ≥ 140 mMol•L −1 could be used as a first-step screening procedure for detecting underhydration in geriatric patients [99]. Similar to LOW, older adults can be encouraged to increase TWI by building upon existing habitual drinking patterns [121].…”

Narrative Review of Low-Intake Dehydration in Older Adults

“…A recent study by Wojszel [ 12 ] also chose to use calculated osmolarity (see Table 1 ) and assessed the correlation between this measure and different patient characteristics. In 209 (58%) patients impending dehydration (>295 mmol/L) was detected at admission to the geriatric department.…”

“…In 209 (58%) patients impending dehydration (>295 mmol/L) was detected at admission to the geriatric department. Impeding dehydration was more frequent in patients with multimorbidity, different chronic diseases and polypharmacy [ 12 ], which are well-known risk factors for low-intake dehydration assessed by measured serum osmolality and described in the ESPEN guideline [ 4 ].…”