Narrative Review of Low-Intake Dehydration in Older Adults.

Anne Marie Beck,Anne Wilkens Knudsen,Tina Munk,Johanna Seemer

doi:10.3390/nu13093142

Anne Marie Beck, Anne Wilkens Knudsen + Show 2 more

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https://doi.org/10.3390/nu13093142

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Abstract

Low-intake dehydration is a common and often chronic condition in older adults. Adverse health outcomes associated with low-intake dehydration in older adults include poorer cognitive performance, reduced quality of life, worsened course of illness and recovery, and a high number of unplanned hospital admissions and increased mortality. The subjective methods to assess (risk of) dehydration are not reliable, and the evidence about preventive measures are also limited. So is the knowledge about the optimal intake of beverages per day. This narrative review presents the state of the science on the role of low intake hydration in older adults. Despite its simple cause—the inadequate intake of beverages—low-intake dehydration appears to be a very complex problem to address and much more research is needed in the area. Based on the existing evidence, it seems necessary to take setting specific differences and individual problems and needs into account to tackle dehydration in older adults. Further, it is necessary to increase awareness of the prevalence and severity of low-intake dehydration among older adults and in nursing staff in care homes and hospitals as well as among caregivers of older adults living at home.

Highlights

The evidence-based recommendations in the ESPEN guideline are based on several systematic literature searches, comprising a total of 33 PICOs (Participant, Intervention, Comparator, Outcomes, study design), which were split into four chapters
For the present narrative review an update of the literature was performed by the first author (AMB) in a three-step approach: (Step 1) Searches for guidelines that address low-intake dehydration and which is not included in the evidence-based recommendations have been updated until 10 April 2021 using Google Scholar and PubMed; (Step 2) Searches for more recent systematic reviews and primary studies were updated to 10 April 2021 by opening each of the references included in the evidence-based recommendations focusing on low-intake dehydration and undertaking a search of “similar articles” in PubMed
A flowchart documenting the updated search strategy and results for each research question (Table 1) is shown in Figure 1 (three separate searches were conducted for requestion (Table 1) is shown in Figure 1

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Low-intake dehydration is often referred to as hypertonic, hyperosmotic, or waterloss, and describes an uncompensated, predominantly pure water deficit [1]. Low-intake dehydration is commonly caused by a beverage intake insufficient to compensate potential fluid losses through urine, feces, breath, and/or sweat [2]. This leads to a concentration of particles within body fluids, a decrease in extracellular fluid volume, and an increase in directly measured serum osmolality [3]

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