During a 2003 heatwave in Europe, over 70,000 people died — most from dehydration. An overwhelming number of these individuals were older adults, in their 70s, 80s and 90s, many of whom lived alone. Gary Egan, a scientist previously affiliated with Melbourne’s Howard Florey Institute, wanted to figure out why some people with access to water could possibly die of dehydration.
His thirst study, a collaboration with the Research Imaging Center at the University of Texas, suggests that people over the age of 65 actually underestimate how thirsty they are. That’s because, at a certain age, humans lose the sensations that ‘tell them’ to hydrate.
Specifically, Egan’s research shows older adults lose their ability to feel thirst because their brains no longer communicate optimally with their bodies. Without a working signal to do so, many seniors, especially those who live alone, simply don’t drink enough water. Egan and his research partners believe that’s what happened in Europe nearly 20 years ago when a significant number of older adults died in the 3-week heatwave.
Chronic Underhydration in the Elderly
Water takes on many jobs in the body, from regulating temperature to helping pump blood to muscles. That’s why dehydration can lead to disorientation and confusion, fatigue and muscle cramps, and even worse consequences. But these “nonspecific” ailments are often misdiagnosed and even chalked up to the natural effects of aging, Anne Vanderbilt, a clinical nurse specialist at the Cleveland Clinic’s Center for Geriatric Medicine told the Cleveland Clinic.
As it turns out, up to 40% of elderly people may be chronically underhydrated, a SAGE Open Nursing study from 2019 notes. Lead author Janet Mentes mentioned in a press release that seniors who are underhydrated and exposed to a virus or bacteria are more likely to develop an infection, such as urinary tract infections, pneumonia or other respiratory diseases. If they are treated for the infection, a clinician may not recognize any underlying underhydration and miss the opportunity to educate the individual about proper fluid intake. In fact, there are “significant deficiencies in hydration health literacy among elderly,” as reported in a 2017 Nutrition and Healthy Aging study.
Dehydration even ranks among the ten most common diagnoses in hospital admissions of elderly people, a 2016 Frontiers in Molecular Biosciences paper found. Further, health issues caused by dehydration accounted for a 5% increase in preventable emergency room visits in adults between 2008 and 2012, costs 1.14 billion dollars a year in the U.S., and results in increased mortality and morbidity.
Solutions for Seniors
Geriatricians know it’s hard for an 80- or 90-year old to drink a full glass of water in one sitting: Bloating and frequent bathroom trips commonly derail most older individuals off the hydration path. Further, research has determined that worries of overnight incontinence leave many older adults waking up dehydrated, which is linked to an increased fall risk. To address these concerns, Vanderbilt suggests offering elderly individuals small sips of water throughout the day and mixing water with flavoring to make it more palatable.