Low-intake dehydration is one of the commonest and most frequent chronic conditions in older adults, which can be associated with adverse health outcomes like poorer cognitive performance, lowered quality of life, worsened course of illness and recovery, and an increased number of unplanned hospital admissions and mortality. 

The subjective methods to evaluate (the risk of) dehydration are not reliable, further limiting the evidence about preventive measures. This also restricts our knowledge regarding the optimal intake of beverages per day. 

Hydration has a crucial role in older adults. Although low-intake dehydration is due to a simple cause as inadequate intake of beverages, it is a very complex problem to address. The evidence from the ESPEN guideline prompted a group of investigators to reach a consensus and also highlighted the importance of considering setting-specific differences and individual problems and needs (e.g., needing to be reminded of drinking, social environment, type of drink and vessel) to tackle low-intake dehydration in older adults. 

Evidence suggests that a more frequent and systematic offering of beverages may improve fluid intake and there might also be a need to focus on beverage consistency, as total fluid intake is higher in those consuming thin vs. thickened liquids. 

Older women are recommended to consume at least 1.6 L of drinks each day, while older men should consume at least 2.0 L of drinks each day unless there is a clinical condition that requires a different approach. All these findings support the ESPEN recommendations.

In general, the current literature reinforces the recommendations communicated in the guideline. It is essential to raise awareness of the prevalence and severity of low-intake dehydration among older adults and in nursing staff in care homes and hospitals as well as in older adults caregivers.

Then more research is needed regarding the identification of dehydrated older adults or those at risk within the clinical setting and with a practical focus, especially among community-dwelling older adults; the adequate interventions to improve fluid intake and the adequate amount of fluid intake.

Source- Nutrients. 2021; 13(9):3142. Https://doi.org/10.3390/nu13093142