The development of a pre-dehydration check sheet for independent community dwelling elderly. -A continuation of research about pre-dehydration among elderly individuals who had been admitted to or regularly visited an elderly-care institution.

Abstract

In the present study, we defined the state of pre-dehydration (PD) as the suspected loss of body fluids, not accompanied by subjective symptoms (serum osmotic pressure: 292-300 mOsm/kg・H2O). The goal of this study was to develop a non-invasive PD check sheet for independent home care for the elderly. We evaluated the serum osmotic pressure of 222 independent community dwelling elderly individuals who were >65 years of age. We then determined the association between the serum osmotic pressure and various dehydration-related diagnostic factors that we identified in a previous study. We performed a logistic regression analysis to determine the risk factors for dehydration and allotted scores based on the odds ratio. We developed a non-invasive PD check sheet consisting of items with high scores and categorized the risks based on the positive predictive value of the total score of the applied items. PD was confirmed in 46 subjects (20.7%) based on their serum osmotic pressure. We developed a PD assessment sheet which consisted of 6 items, (1) Dislike rehydrating before sleeping, as it induces the need to use the toilet (3 points), (2) Using diuretics (8 points), (3) Casual blood sugar ≥126 mg/dl (9 points), (4) Age ≥85 years (3 points), (5) Male sex (4 points), (6) Body weight ≥60 kg (3 points). Patients with a score of >13 points on this sheet were considered to have a high risk of PD (maximum score: 30 points) (positive predictive value, 72%; negative predictive value, 85.6%; P<0.0001). In the present study, we found that 20.7% of elderly subjects had PD. Based on these data, we developed an effective noninvasive tool for detecting PD among independent community dwelling elderly.