Ageless Conversations - February 9, 2025

Drink More Water - Dehydration in Older Adults

To be honest, as I read the studies on dehydration in older adults I was disturbed. I knew that we are composed mostly of water, and I knew that staying hydrated makes our skin and other organs more healthy in a general way. But I didn’t know that up to one in three senior citizens are dehydrated, and I didn’t know all the reasons why. And I certainly didn’t know how dangerous that is, so I need all of you other old fogies to learn about hydration!!

Why Older Adults Are at Higher Risk of Dehydration

Here are several things I learned about the aging population:

Thirst decreases, so older adults don’t feel thirsty even when the body needs water.
Total body water drops, meaning dehydration happens faster.
Kidneys become less efficient, making it harder to conserve water.
Medications (especially diuretics, some heart meds, and certain psychiatric drugs) increase fluid loss.
Mobility, vision, or cognitive issues can make it harder to get drinks regularly.
Fear of incontinence leads many older adults to intentionally drink less..

Combine these factors and dehydration becomes extremely common in people over 65.

I actually have experience with that last bullet point, and it was pretty bad when I was in the hospital. I couldn’t get out of bed or walk without assistance, which meant calling for a nurse, waiting for them, and then very slowly getting to the toilet. To be blunt, I knew that if I drank as much as I wanted to, I would pee my pants and the bed. When the nurses caught wind of this they of course lectured me and made me wear a big pad thing. Oh the humiliation! I get it. But I’d rather wear a pad than be extremely ill or dead, so I’ve decided I'm no longer embarrassed by pads, and if I have to wear one, I will.

Why Hydration Matters So Much for Older Adults

The studies I read said that even mild dehydration can cause major problems:

- Fatigue, weakness, dizziness, and falls–yeah, falls. That thing we don’t wanna do.
- Confusion, irritability, and memory problems–delightful.
- Constipation and urinary tract infections
- Worsening of chronic conditions (kidney disease, diabetes, heart issues)
- Higher risk of hospitalization and complications
- Poorer recovery after illness or surgery–did you know that hospitalized pneumonia patients are twice as likely to die in the next 6-12 months if they are dehydrated?

Hydration is directly tied to mobility, cognition, mood, and independence.

How Much Should Older Adults Drink?

There is no one-size-fits-all number, but most older adults need steady fluid intake throughout the day, not just when thirsty.

General guidance from the studies:

• Men: about 85 ounces (3.7 liters)--that’s a bit more than two and a half 32oz drink bottles.
• Women: about 64 ounce (2.7 liters)--two full drink bottles.
• Fluids should be spread out across the day–keep your bottle by you and keep sipping!
• Needs increase with heat, exercise, fever, or illness–stay in the shade or AC and drink more.
• Some conditions (heart failure, kidney disease) may require limits—always follow medical guidance.

I’ve been dedicated to drinking more water lately, so yeah, I've made lots of trips to the bathroom. I set myself up with my laptop for work in a comfy chair not too far from said bathroom and yes, my frequent toileting is annoying. But the science says that my body will soon adjust to my new and improved habits, and my potty pauses will decrease. The same goes for you. We must be patient, old Padawans.

Key Takeaway

Extra Content For Caregivers

I wish I had known more about hydration when my parents were alive and living with us. Pretty sure my stubborn old adorable coot of a dad would have done whatever he wanted, but at least I could have bought him a fancy drink bottle and made sure he had it filled and near him at all times. Plus the mandatory glass of Fresca. Anyway, many of you in your sixties and seventies still take care of parents in their eighties or nineties. Here is an important hydration checklist for you.

Sources: Hydration Strategies in Older Adults https://pubmed.ncbi.nlm.nih.gov/37330324/
westminster.ac.uk Dehydration in older people: A systematic review of the effects of dehydration on health outcomes, healthcare costs and cognitive performance
Dehydration and hospital-associated disability in acute hospitalized older adults M Nagae, H Umegaki, H Komiya, C Fujisawa, K Watanabe, Y Yamada, S Miyahara European Geriatric Medicine, 2023•Springer