Prevalence and Risk Factors Associated With Low Fluid Intake in Institutionalized Older Residents

Botigué, Teresa; Masot, Olga; Miranda, Jéssica Steffany; Nuín, Carmen; Viladrosa, Maria; Lavedán, Ana; Zwakhalen, Sandra

doi:10.1016/j.jamda.2018.08.011

Cited by 27 publications

(26 citation statements)

References 37 publications

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“…Deterioration in immune system functions, known as immunosenescence, is also well documented in the older adult population and is acerbated by poor nutritional status [10,11]. Sarcopenia and immunosenescence are presented as predisposing factors to aspiration pneumonia in frail older adult populations [12][13][14][15][16] further complicating the evaluation of the causes of recurrent aspiration pneumonia in this population. Providing nutritious and safe texture modified foods are key elements in mitigating dysphagia impacts ( Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Is IDDSI an Evidence-Based Framework? A Relevant Question for the Frail Older Population

Côté

Giroux²,

Villeneuve-Rhéaume

et al. 2020

Geriatrics

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To delay impacts of aging, optimal nutritional status is essential. Several factors can reduce food intake, such as isolation, income, and cognitive/physical decline. Additionally, chewing and swallowing difficulties, or dysphagia, often disrupt the ability to consume life-long favorite dishes. Food and liquids could require modification of texture or consistency to ensure a comfortable or safe swallow. The food industry, foodservices facilities, and caregivers need quality control benchmarks to provide adequate nourishment and meet these new feeding challenges. The International Dysphagia Diet Standardisation Initiative (IDDSI) is proposing the IDDSI framework and testing methods to describe food used in nutritional care plans to circumvent dysphagia and improve communication among caregivers. This systematic review assesses the validity and reliability of the IDDSI testing methods using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Two publications presented content validity whereas 19 publications looked at construct validity or reliability for the IDDSI testing methods. One study was conducted in older adults presenting dysphagia. This review concludes that there is insufficient evidence to recommend the IDDSI testing methods. Further research, conducted with robust methodological design and reporting, is needed to develop and assess nutritious adapted food for frail older populations.

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Section: Introductionmentioning

confidence: 99%

Is IDDSI an Evidence-Based Framework? A Relevant Question for the Frail Older Population

Côté

Giroux²,

Villeneuve-Rhéaume

et al. 2020

Geriatrics

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“…In addition, decline in ADL is associated with severity of dementia in nursing home residents [38]. A previous study reported that low BI scores were associated with low fluid intake [7]. Nursing home residents with dementia that exhibit functional decline also require assistance to maintain sufficient fluid intake.…”

Section: Discussionmentioning

confidence: 99%

“…Older adults are considered at risk for chronic dehydration due to their reduced sensitivity to thirst, lower urine concentrating ability, and lower fluid intake compared with young or middle-aged adults [5,6]. Furthermore, older nursing home residents may be at high risk for chronic dehydration because lower fluid intake is commonly observed in nursing home residents [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…In clinically stable long-term care residents, elevations of serum osmolality were frequently observed without clinically overt signs of dehydration [14], so using serum osmolality to assess chronic dehydration is considered reasonable. Chronic dehydration may be more problematic among nursing home residents [7,8], and establishing effective preventive strategies for chronic dehydration in this population would require identifying the risk factors for chronic dehydration.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Dehydration in Nursing Home Residents

et al. 2020

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Chronic dehydration mainly occurs due to insufficient fluid intake over a lengthy period of time, and nursing home residents are thought to be at high risk for chronic dehydration. However, few studies have investigated chronic dehydration, and new diagnostic methods are needed. Therefore, in this study, we aimed to identify risk factors for chronic dehydration by measuring serum osmolality in nursing home residents and also to evaluate whether examining the inferior vena cava (IVC) and determining the IVC collapsibility index (IVC-CI) by ultrasound can be helpful in the diagnosis of chronic dehydration. A total of 108 Japanese nursing home residents aged ≥65 years were recruited. IVC measurement was performed using a portable handheld ultrasound device. Fifteen residents (16.9%) were classified as having chronic dehydration (serum osmolality ≥295 mOsm/kg). Multivariate logistic regression analysis showed that chronic dehydration was associated with dementia (odds ratio (OR), 6.290; 95% confidential interval (CI), 1.270–31.154) and higher BMI (OR, 1.471; 95% CI, 1.105–1.958) but not with IVC or IVC-CI. Cognitive function and body weight of residents should be considered when establishing a strategy for preventing chronic dehydration in nursing homes.

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“…The variables help determine strategies and targeted interventions to improve fluid intake. Another study of institutionalized residents over age 65 years suggested that a third ingested less than 1500 mL/day; the highest correlation existed with cognitive and functional impairment, risk of suffering pressure ulcers, texture of diet, dysphagia, and BUN:creatinine ratio (Botigue et al 2019). These findings highlight the scale of inadequate fluid intake in long-term care institutions and indicate the need to promote fluid intake to reduce incidence of dehydration in nursing homes; residents commonly suffer from fever and worsening of cognition (with development of delirium), during which time, the responsibility to increase fluid intake rests with the staff and/or caregiver, since residents, seldom if ever, will complain of thirst.…”

Section: Fluid Management In Settings Relevant To the Oldmentioning

confidence: 99%