Physiological changes related to aging can lead to fluid and electrolyte imbalances that may cause morbidity and mortality in even healthy older adults. The present study highlighted the key aspects of age-related pathophysiological changes that affected fluid and electrolyte balance in older adults and underscored their importance in the perioperative period.

It searched the Web of Science, MEDLINE, PubMed, and Google Scholar databases using key terms for relevant studies. And found-

• Dehydration and electrolyte abnormalities in older adults can be caused by various factors, including physical disabilities that limit fluid intake to iatrogenic factors such as polypharmacy and unmonitored diuretic use.
• Renal senescence, as well as physical and mental decline, boosts this susceptibility.
• Older adults are also predisposed to water retention and related electrolyte abnormalities, which get exacerbated during physiological stress.
• Positive fluid balance stands as an independent risk factor for morbidity and mortality in critically ill patients with acute kidney injury.

This study shows that Age-related pathophysiological changes in the handling of fluid and electrolytes make older adults undergoing surgery a high-risk group. Understanding these changes will enable better management of fluid and electrolyte therapy in older adults.

El-Sharkawy AM, Sahota O, Maughan RJ, Lobo DN. The pathophysiology of fluid and electrolyte balance in the older adult surgical patient. Clinical Nutrition. 2014;33(1):6-13. https://doi.org/10.1016/j.clnu.2013.11.010.