Abstract
Dehydration is common among elderly people. The aim of this study was to perform validation analysis of a geriatric dehydration-screening tool (DST) in the assessment of hydration status in elderly people. This tool was based on the DST proposed by Vivanti et al., which is composed by 11 items (four physical signs of dehydration and seven questions about thirst sensation, pain and mobility), with four questions extra about drinking habits. The resulting questionnaire was evaluated in a convenience sample comprising institutionalized (n = 29) and community-dwelling (n = 74) elderly people. Urinary parameters were assessed (24-h urine osmolality and volume) and free water reserve (FWR) was calculated. Exploratory factor analysis was used to evaluate the scale’s dimensionality and Cronbach’s alpha was used to measure the reliability of each subscale. Construct’s validity was tested using linear regression to estimate the association between scores in each dimension and urinary parameters. Two factors emerged from factor analysis, which were named “Hydration Score” and “Pain Score”, and both subscales showed acceptable reliabilities. The “Hydration Score” was negatively associated with 24-h urine osmolality in community-dwelling; and the “Pain Score” was negatively associated with 24-h urine osmolality, and positively associated with 24-h urine volume and FWR in institutionalized elderly people.
Highlights
Dehydration is a common condition among elderly people being considered a precipitating factor for a number of acute medical conditions
Socio-demographic data presented in Table 1 showed that the institutionalized elderly individuals were significantly older than the community-dwellers (82.5 ± 7.2 vs. 70.2 ± 6.0 years, p < 0.001)
It is difficult to establish a direct relationship between thirst and hydration status [33]. These results suggest that “Hydration Score” may be useful in the assessment of hydration status in community-dwelling, but not in institutionalized elderly people
Summary
Dehydration is a common condition among elderly people being considered a precipitating factor for a number of acute medical conditions. It is not clear if there is any causal relationship, there is an association between a low usual fluid intake and some chronic diseases, including urolithiasis, constipation, asthma, cardiovascular disease, diabetic hyperglycemia, and some cancers [1]. Dehydration may precipitate impaired cognitive function, falling, renal failure, pressure ulcers, and poor control of hyperglycemia in diabetes [2]. Considering that prevention of dehydration may improve health, functional status and quality of life [4], the development of a practical dehydration screening method that could be applied by caregivers without specific clinical skills, would be important to identify older people at risk and prioritize resources for diagnosis and treatment [5]
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