Friends, I am delighted to greet this New Year, 2022, with you! I have been so looking forward to celebrating 2022 with you, wishing you always good health, wellness and maximum independence. And here we are!
Ladies and gentlemen, last July, I wrote to you about the “Gift of Water” and the importance of staying hydrated. I reported to you on the findings of a 2018 study that enrolled 170 community dwelling elders where only 56% of the respondents reported consuming greater than 6 glasses of fluid a day, whereas 9% reported less than or equal to 3 glasses. About 60% of respondents overestimated the amount of fluid loss at which they could experience moderate severe dehydration (Picetti, Foster, Pangle, et al., 2017). Also, the majority of respondents were not aware that improper hydration or changes in hydration status can result in complications – kidney problems or heart failure with fluid overload (Picetti, Foster, Pangle, et al.)
I worried if you were keeping yourself hydrated in the summer months, because the evidence confirms that dehydration increases the risk of falls. I still worry if you are taking in enough fluids over the winter months.
Let me remind you that dehydration occurs when your body loses more fluid at a greater rate than the body can replace it (Duarte, Bouca-Machado, Domingos, et al., 2018), and can cause you to feel lightheaded and dizzy. Older persons have reduced sensation of thirst, meaning that you may not realize you need fluids. Symptoms of dehydration include sluggishness, confusion, dizziness (as mentioned), and dark urine.
While evidence exists of the risks between dehydration and falls, little information has been reported on the prevalence of dehydration and of patients who fell while they were dehydrated.
I recently found a study with a larger population that provides even more compelling evidence that links dehydration to two outcomes: (1) falls and (2) falls or deaths – Hamrick, et al. (2020). Researchers from two universities, University of Cincinnati and University of Wisconsin, conducted their study to fill this gap and expand more information about the relationships to medications, patient characteristics, and more.
Hamrick, et al. (2020) reviewed electronic health records of a Midwestern populations of elders 65 and older, 2011-2015, examining the relationship between dehydration and falls within 3 years, while considering medications such as diuretics, antidepressants, and other medications. They examined the records of 30,634 patients, and 37.9% of the patients were dehydrated. Yes, more than one third of the older adults were dehydrated. Also, 11.4% had at least one fall during follow-up, 11.7% died, and 21.1% had either a fall or loss of life. Dehydration had a statistically positive association with both outcomes, falls and falls or death. I encourage, if you would like more information about their findings, to read this article located here.
Their findings provide even more information about the importance of preventing dehydration among older adults. In addition to feeling less thirsty, body water content decreases from 70% at birth to 40% in older women and 45% in older men, leading to less fluid reserve in our body. These two factors, greater fluid losses in urine and less fluid reserve, contribute to increase negative effects of dehydration. Therefore, it is so important to get adequate fluid intake.
They report that the Institute of Medicine recommends differing fluid intake by gender: 91 oz just slightly more than 11 cups) for women and 125 ounces (almost 16 cups) for men, with about 80% coming from beverages. I have been diligent to consume at least 8 cups of water a day, supplemented by other fluids. I am going to step up my intake!
Because our thirst is decreased, they suggest simple, easy strategies to help encourage, remind and assure us of this intake which I just have to pass on to you.
- Arrange 8 toothpicks near a sink on one side. After drinking a glass of water, move a toothpick to the other side of the sink until all toothpicks are moved over to the other side of the sink by the end of the day.
- Fill a half gallon pitcher of water that needs to be drunk by the end of the day. And enjoy throughout the day. This strategy is my new strategy!
- Associate drinking with a common activity such as seeing a TV commercial or answering an email
- Use a smartphone app that has an alarm and sent reminders (Hamrick, et al, 2020, p. 264)
Always remember, proper hydration is an essential health practice for your body’s vital organs. Water, increased fluids, is essential to your life!
You and your healthcare team can assure that your daily fluid intake is adequate for proper hydration, but only you can make sure you drink enough fluids.
Remember, you cannot rely of being thirsty and that water is your body’s friend. If you are on fluid restrictions, talk with your primary provider to verify your recommended amount of you fluid integrate.
Stay strong, active, safe, and connected with your healthcare team.
Your Harmony Team is here to help you!
Thank you for reading this message and in advance for sharing with others.
Wishing you a very special Holiday Season,
Hamrick, I., Norton, D., Birstler, J., Chen, G., Cruz, L., & Hanrahan, L. (2020). Association between dehydration and falls. Mayo Clinic Proc Innov Qual Outcomes, 4(3): 259-265.
Accessed Dec. 10, 2021.
Picetti, D., Foster, S., Pangle, A., Schrader, A., George, M., Wei, J., & Azhar, G. (2017). Hydration health literacy in the elderly. Nutr. Healthy Aging, 4(3): 227-237. Available: