One in five older people at risk of dehydration in care homes

New research has revealed that older people are increasingly at risk of suffering from dehydration in care homes, particularly if they are living with dementia or diabetes.

Researchers from the Universities of East Anglia (UEA) and Canberra found that those with long-term health conditions were most at risk of dehydration due to insufficient intake of liquids.

Lead researcher at UEA’s Norwich Medical School, Dr Lee Hooper, said: “Water is crucial to every bodily action and maintenance of hydration is essential to life. We know that dehydration is difficult to identify - but it can lead to increased risk of hospital admission, urinary tract infections, disability and even death.

“Older people tend not to feel thirsty when they drink too little. On top of that - as our kidneys get older we are less able to concentrate our urine to preserve fluid, so the body’s ability to regulate its fluid balance slowly reduces.

“Until now, there has been limited and contradictory evidence about which health factors are associated with dehydration in older adults. We wanted to find out whether any particular conditions are associated with dehydration in order to understand its prevalence and pinpoint which individuals are most at risk.”

The Public and Patient Involvement in Research (PPIR) which was funded by the National Institute of Health Research (NIHR) took place across 56 residential care homes where researchers studied 188 over 65s.

The volunteers’ hydration status was determined by a serum osmolality blood test and the results were classified as ‘normally hydrated’, ‘impeding dehydration’, and ‘dehydrated’.

Researchers compared the results with a range of 67 different cognitive, functional and health factors including continence, thirst, temperature, weight, medication and whether they had been diagnosed with dementia.

The report revealed that there was a high prevalence (20 per cent) of dehydration in older people living in long-term residential care, particularly those living with kidney problems, dementia and diabetes.

Commenting on the findings, Dr Hooper added: “We found that older people who had been in poor health - those who had been to the doctor more often or had a recent history of emergency admissions – were more likely to be dehydrated.

“Volunteers with swollen ankles, chronic obstructive pulmonary disease (COPD), arthritis, continence issues, dementia and those using medications for diabetes were also particularly at risk.

“We also found that men were more likely to be dehydrated than women and that thirst is a poor indicator of dehydration in older people. Drinking must instead be regulated by habit and routine which can be difficult for people with dementia.”

He continued: “We found a strong correlation between both poor cognitive function and dehydration, but it is quite possible that dehydration is the cause of poor cognitive function, and that the relationship works in a vicious circle.

“We hope that this research will enable carers to pinpoint which frail older people are most likely to suffer dehydration. More research is needed to assess the direction of causation and the health effects of increasing fluid intakes.”