Health & Exercise Forum

BENEFITS OF ADEQUATE HYDRATION IN THE ELDERLY

Part 2 of 3 on Dehydration in the Elderly

Water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluid loss also contributes and complicates many health issues. If you are elderly or care for the elderly, understand that this may be one problem that you can often control. It is important for you to understand the many conditions complicated by dehydration.

Good hydration prevents the development of the following ailments:

• PRESSURE ULCERS: Poorly hydrated individuals are twice as likely to develop pressure ulcers because dehydration reduces the padding over bony points. Adequate fluid intake increases levels of tissue oxygenation and enhances ulcer healing.
• CONSTIPATION: Inadequate fluid intake is one of the most frequent causes of chronic constipation. Drinking more water can increase stool frequency and enhance the beneficial effect of daily dietary fiber intake.
• URINARY INFECTIONS AND INCONTINENCE: Water helps maintain a healthy urinary tract and kidneys. Many older people avoid fluid consumption in the evening in an attempt to eliminate the need to go to the bathroom at night. The restriction of overall fluid intake DOES NOT reduce urinary incontinence, frequency, or severity.
• KIDNEY AND GALLSTONES: Good hydration reduces the risk of kidney stone formation because dilute urine helps to prevent crystallization of stone-forming salts. Consumption of water at regular intervals dilutes bile and stimulates gallbladder emptying, which in turn prevents gallstone formation.
• HEART DISEASE: Adequate hydration reduces the risk of coronary heart disease by 46% in men and 59% in women. It also protects against blood clot formation by decreasing blood viscosity.
• LOW BLOOD PRESSURE: Many older people suffer from a drop in blood pressure on standing, which sometimes causes them to pass out. Drinking a glass of water five minutes before standing helps stabilize blood pressure and prevents fainting.
• DIABETES: Water is an essential part of the diabetic management since dehydration can worsen diabetic control. If diabetes is poorly controlled, high urine output increases the risk of dehydration.
• COGNITIVE IMPAIRMENT: Mild dehydration causes light-headedness, dizziness, headaches, and tiredness, reduced alertness and inability to concentrate. Once thirst is felt, mental function may be affected by as much as 10%. Mental performance deteriorates progressively as the degree of dehydration increases.
• FALLS: Fall risk increases with age. The resultant injury can lead to a reduced quality of life. These individuals may not return to independent living. Dehydration is one of the risk factors for falls in older people since it leads to a deteriorated mental state and increased risk of dizziness and fainting. Adequate hydration prevents falls and, in hard water areas, provides a significant source of dietary calcium, essential for bone density and the prevention of osteoporosis.
• HOSPITALIZATIONS IN OLDER PEOPLE: Dehydration increases the mortality, by two-fold, of patients admitted to the hospital with stroke. It also increases the length of hospital stay for patients with community-acquired pneumonia.
• SKIN PROBLEMS: Being well hydrated keeps skin healthy and young looking. The skin acts a water reservoir and participates in fluid regulation for the whole body. Mild dehydration, more noticeable on the face, causes skin to appear flushed, dry, and loose, which makes it look older than it is.
• CANCERS OF THE LARGE BOWEL, BREAST, AND URINARY TRACT: Consuming 4 to 5 glasses of water daily reduces the risk of colon cancer: 45% in women and by 32% in men. Water may help to dilute toxic compounds in the bowel and speed the passage of stool so that any harmful substances spend less time in contact with the bowel. Good hydration reduces the risk of breast cancer: 33% for pre-menopausal women and 79% for postmenopausal women. Dehydrated cells are less able to remove harmful substances. People with low fluid intake are more likely to develop urinary tract cancers (prostate, bladder, kidney, and testicular cancer). In women, bladder, renal pelvis, and ureter cancer declines in proportion to the total amount of fluid consumed. Water appears to have the strongest protective effect. In men, consumption of more than 2.5 liters of water per day is associated with a 51% reduction in bladder cancer risk. Higher levels of fluid consumption may reduce contact between the bladder and carcinogens by diluting the urine and increasing the frequency of urination. However, if the fluids consumed contain substances that are carcinogenic to the bladder (i.e. coffee and alcohol), the risk of bladder cancer can be increased.

Visit your doctor regularly and listen to your body.

Keep moving, eat healthy foods, exercise regularly, and live long and well!

CONTRIBUTOR: Janet M. Caputo, PT, DPT, OCS – is an associate and clinic director at Mackarey Physical Therapy in Scranton, PA, where she specializes in outpatient orthopedic and neurologic rehab.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune. Next Week, read Part 3 of 3: “Prevention of Dehydration”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.