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.
Highlights
Different factors make older people especially prone to dehydration, and old age is pointed as an important determinant of inadequate hydration in hospitalized patients [1,2]
Was assessed with the Barthel Index [25] and 6 instrumental activities of daily living (ADL) items of Duke OARS scale- IADL [26]. It included the results of other tests and scales, collected within comprehensive geriatric assessment performed in the department: the Abbreviated Mental Test Score (AMTS) [27], Geriatric Depression Scale (GDS) [28], the Performance Oriented Mobility Assessment (POMA) [29] and the Timed Up and Go test (TUG) [30]
The results of the analysis suggested the model with 4 variables only: chronic kidney disease, diabetes, taking procognitive medications, and hypertension
Summary
Different factors make older people especially prone to dehydration, and old age is pointed as an important determinant of inadequate hydration in hospitalized patients [1,2]. Older adults do not perceive water as an essential nutrient and many intrinsic and extrinsic factors are connected with the increased dehydration risk in this population The former ones include age-related physiological changes (decline in intracellular water and fluid reserves, changes in renal function, resulting in the inability to concentrate urine, altered thirst perception), diseases combined with increased fluid loses because of vomiting or diarrhea, and changes in the functional status of an older person (such as cognitive disability or mobility impairment resulting in restricted fluid intake).
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