There are many factors that can lead to a Senior experiencing an unintended fall, however, dehydration may be one of the more dangerous factors due to its impact on so many other systems in the body. Falls can be devastating and around 50% of falls have psychological consequences too.(*1) Dehydration may be more common in the Senior population than you realize. In fact, dehydration affects 20%-30% of older adults.(*7) It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity and disability.(*7)
What, exactly, is dehydration and how does this happen? Dehydration occurs when you use or lose more fluid that you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions.(*6) As we age, there are many changes that occur to the body and the way we process and metabolize water changes a bit too. Older adults are at great risk for dehydration because of several normal aging changes that occur throughout our lifespan. As we age, we feel less thirsty because of apoptosis of the hypothalamus, the thirst center location. Apoptosis of neurons in the pituitary result in decreased antidiuretic hormone production. The aging kidney is less responsive to antidiuretic hormone and less able to concentrate urine with increasing age. Our body water content also decreases from 70% at birth to 40% in older women and 45% in older men, leading to decreased fluid water reserve. In addition, many older adults limit their fluid intake in an attempt to prevent urinary and fecal incontinence.(*4) In my experience, I have had Seniors tell me that they just don’t think about drinking water or they do not feel thirsty. Also, on a few occasions, I’ve been told that some just do not like the taste or want to drink water.
So, how does this increase the potential for falls in the Senior population? Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration.(*6) According to a study from University of Wisconsin, out of 30,634 patients that had been admitted into the hospital for some other reason, 37.9% were dehydrated, 11.4% had a fall during follow-up and 11.7% died during the follow-up period. They concluded that there was positive association of dehydration with falls alone!(*4) Dehydration impacts the muscular system and nervous system in a huge way. In my practice, I hear from many of my Senior clients say that they have trouble sleeping due to leg cramps and drowsiness is a collateral impact and can lead to a fall. Also, cognitive ability slows when one is dehydrated.
What are symptoms of dehydration in older adults?(*6)
- Extreme thirst
- Less frequent urination
- Dark-colored urine
When should you see or contact a doctor?(*6)
- If you have had diarrhea for 24 hours or more
- Are irritable or disoriented and much sleepier or less active than usual
- Can’t keep fluids down
- Has bloody or black stool
Let’s get to some answers… I’ve written about all the problems and issues dehydration can cause. So, how can we avoid dehydration? The daily amount of water a Senior should drink depends on body weight, age, medication use and fitness and activity levels. In general, a good rule is to divide your weight in half to calculate daily water intake by ounces.(*5) A good rule of thumb that most follow is that if one feels thirsty, that is the first stage of dehydration. So, drink up!!
The takeaway, dehydration is easily preventable. I’ve seen caregivers and adult children lay out bottles of water just like one would do for a pill schedule. Determine how much water should be drank, then construct a schedule that is conducive to reaching that goal. If you’re caring for a Senior, or you are a Senior, that needs a little flair to their water, there are many flavoring additive products out there that can change the flavor of water and make it more palatable.
Falls are not a necessary part of aging but it does take a bit of effort to avoid an unintended fall!
Chris R. Williams
For more information:
- SafeAtLast (20+ Fall Statistics That Will Make You More Careful Today)
- Great Senior Living (Dehydration in Elderly People: Risks, Warning Signs and Prevention Tips)
- Nutrition and Healthy Aging
- PubMed.gov (Association Between Dehydration and Falls)
- The Daily Meal (We Asked 10 Nutritionists How Much Water Should We Really Drink)
- Mayo Clinic (Dehydration in Seniors and Falls)
- Mayo Clinic (Dehydration in the Older Adult)