Ferry Monique
Centre Hospitalier Universitaire, Service de Gériatrie, 179 Blvd. du Maréchal Juin, F-26953 Valence 9, France.
Nutr Rev. 2005 Jun;63(6 Pt 2):S22-9. doi: 10.1111/j.1753-4887.2005.tb00151.x.
Dehydration is a frequent etiology of morbidity and mortality in elderly people. It causes the hospitalization of many patients and its outcome may be fatal. Indeed, dehydration is often linked to infection, and if it is overlooked, mortality may be over 50%. Older individuals have been shown to have a higher risk of developing dehydration than younger adults. Modifications in water metabolism with aging and fluid imbalance in the frail elderly are the main factors to consider in the prevention of dehydration. Particularly, a decrease in the fat free mass, which is hydrated and contains 73% water, is observed in the elderly due to losses in muscular mass, total body water, and bone mass. Since water intake is mainly stimulated by thirst, and since the thirst sensation decreases with aging, risk factors for dehydration are those that lead to a loss of autonomy or a loss of cognitive function that limit the access to beverages. The prevention of dehydration must be multidisciplinary. Caregivers and health care professionals should be constantly aware of the risk factors and signs of dehydration in elderly patients. Strategies to maintain normal hydration should comprise practical approaches to induce the elderly to drink enough. This can be accomplished by frequent encouragement to drink, by offering a wide variety of beverages, by advising to drink often rather than large amounts, and by adaptation of the environment and medications as necessary.
脱水是老年人发病和死亡的常见病因。它导致许多患者住院，其后果可能是致命的。事实上，脱水常与感染有关，如果被忽视，死亡率可能超过50%。研究表明，老年人比年轻人患脱水的风险更高。随着年龄增长水代谢的改变以及体弱老年人的液体失衡是预防脱水时需要考虑的主要因素。特别是，由于肌肉量、总体水量和骨量的减少，老年人中无脂肪组织减少，而无脂肪组织含有水分且水分含量为73%。由于水的摄入主要受口渴刺激，且口渴感会随着年龄增长而下降，脱水的风险因素是那些导致自主能力丧失或认知功能丧失从而限制获取饮料的因素。脱水的预防必须是多学科的。护理人员和医护专业人员应时刻了解老年患者脱水的风险因素和体征。维持正常水合作用的策略应包括促使老年人喝足够水的实际方法。这可以通过频繁鼓励饮水、提供多种饮料、建议少量多次饮水以及必要时调整环境和药物来实现。
