The Dangers of Dehydration in Older Adults

As the weather begins to heat up, it makes me think of dehydration and the effects it can have on older adults. As a physical therapist, working with older adults in their homes, I have seen firsthand the dangers of dehydration on the older adult population.

We all know that dehydration can cause severe symptoms at any age, but as an older adult, dehydration symptoms are vastly different from their younger counterparts. Research has shown that 48% of all older adults admitted to the hospital showed signs of dehydration. Most of them had no idea they were dehydrated. In some cases, dehydration developed into a further complication which lead to the hospitalization.

So, what are the effects of dehydration in older adults?

The effects of dehydration are sometimes mild but can lead to serious complications and even death. Some of the most common effects are:

  1. Weakness
  2. Dizziness
  3. Falls
  4. Loss of consciousness
  5. Low blood pressure (can lead to falls with changes in position)
  6. Rapid and weak pulse
  7. Confusion or altered mental status
  8. Urinary tract infections (UTI’s)
  9. Difficulty walking

So why do older adults become dehydrated more than younger adults?

Dehydration happens for many reasons. Most commonly it is due to inadequate water intake, but it can also be caused from diarrhea, vomiting, excessive sweating, loss of blood, Diabetes, or medications such as diuretics (i.e., Lasix).

However, the aging process alone can cause us to become more dehydrated. Aging can cause people to be less aware of thirst and it gradually lowers the body’s ability to regulate its fluid balance.  This makes us less likely to notice we should drink more.

The body also loses water as we age due to loss of muscle mass and an increase in fat cells. In addition, our bodies lose kidney function and are less likely to conserve our fluid.

I have also witness as a physical therapist that due to mobility issues, older adults might feel it is too much effort to get up to go get something to drink or have concerns it will just lead to having to go to the bathroom more (especially at night). If you have concerns it will cause you to have to get up in the middle of the night, try drinking water throughout the day versus waiting until evening to consume most of your fluid intake.

No one wants to go to the hospital, and it can sometimes be avoided by staying hydrated.

What are the benefits of being hydrated?

These are the most common benefits of staying hydrated:

  1. Less laxatives due to constipation
  2. Fewer falls
  3. For men, it decreases the risk for bladder cancer
  4. Five ounces of water a day, decreases your risk for coronary heart disease
  5. Can help regulate your blood pressure
  6. Regulates the body’s temperature, brain function, the digestive system and kidney function

So how do you know if you are dehydrated and what can you do about it?

There are several ways to recognize dehydration symptoms and understand if they are mild or more serious.

  1. MILD SYMPTOMS: unable to urinate or it is dark or deep yellow, cramping in the arms or legs, headaches, irritability or increased sleepiness and a generalized feeling of overall weakness.
  2. MORE SEVERE SYMPTOMS: low blood pressure which can lead to dizziness/lightheadedness or syncope (passing out) with changes in position such as sit to stand, convulsions, severe cramping, bloated stomach, rapid but weak pulse, urinary tract infections (UTI’s), dry or sunken eyes, breathing faster than normal and less skin elasticity. Of even more of concern, dehydration can lead to damage of internal organs such as the kidneys, liver, and brain.

Recognizing these symptoms when they are in the mild phase is the key to keeping yourself out of the hospital and risking further complications. If you recognize these symptoms in the mild stages, it can usually be reversed by properly hydrating and increasing your water intake. A sign that you have properly rehydrated, is that your urine will turn to a pale-yellow color.

The more severe symptoms may require medical attention. Many times, older adults are experiencing symptoms of dehydration and do not realize it. Therefore, they end up going to the hospital because of a fall, UTI or some other concern. When in fact, it was the dehydration that lead to those concerns which could have possibly been avoided with proper hydration.

So how do you know how much to hydrate?

This can be different for each individual based on activity levels, medical conditions and types of medications. It is always best to consult with your doctor to determine the right amount of hydration for you. However, there is a generalized formula for determining hydration:

1/3 body weight (in pounds) = ounces of water needed daily

In conclusion, staying hydrated is extremely important as we age because our bodies do not always alarm us that we need to drink more. Consequently, we need to pay more attention to the symptoms of dehydration to avoid a hospitalization or further complication.