Schols J M G A, De Groot C P G M, van der Cammen T J M, Olde Rikkert M G M
Nursing Home Medicine, Department of General Practice, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
J Nutr Health Aging. 2009 Feb;13(2):150-7. doi: 10.1007/s12603-009-0023-z.
Translate the available knowledge on ageing and dehydration into main messages for clinical practice.
Older people are more susceptible to dehydration than younger people. This is partly due to lack of thirst sensation and changes in the water and sodium balance that naturally occur as people age. It is also, to some degree, attributable to the fact that elderly people, both those living at home and those living in institutions, often have various impairments, disabilities and/or handicaps (comorbidity). They also tend to use numerous drugs and medication for these illnesses (polypharmacy). Multimorbidity and polypharmacy often overstress the normal age-related physiological changes in the water and sodium balance and therefore increase elderly people's risk of dehydration,especially during intercurrent infections or warm weather. Elderly people, whether they are living on their own or in an institution, and especially elderly people that can no longer take care of themselves because of cognitive, sensory, motor and/or ADL impairments, need extra help to stay hydrated. The most important strategy is simply a matter of ensuring that elderly people consume a sufficient amount of fluids (at least 1.7 liters every 24 hours). Additional strategies include making healthy drinks and water easily available and accessible at all times and reminding and encouraging the elderly to consume these fluids. Elderly people should not be encouraged to consume large amounts of fluids at once but rather small amounts throughout the day. When the recommended fluid intake cannot, for whatever reason, be realized, fluids can be administered via catheter or by hypodermoclysis. In more specific and severe cases, fluids can be administered intravenously.
The prevention, signaling and treatment of dehydration in the elderly is an important multidisciplinary endeavor. Formal and informal care providers need to continuously be aware of the risk factors and signs of dehydration in the elderly, especially during periods of very warm weather and when older people are ill. Standard professional care for high risk patients is imperative.
将关于衰老和脱水的现有知识转化为临床实践的主要信息。
老年人比年轻人更容易脱水。部分原因是随着年龄增长，口渴感缺失以及水和钠平衡的自然变化。在一定程度上，这也归因于居家和机构养老的老年人往往存在各种损伤、残疾和/或障碍（共病）。他们还常常因这些疾病使用多种药物（多重用药）。共病和多重用药往往会过度加重与年龄相关的正常水和钠平衡生理变化，从而增加老年人脱水的风险，尤其是在并发感染或天气炎热时。老年人，无论独居还是住在机构中，尤其是那些因认知、感官、运动和/或日常生活活动能力受损而无法自理的老年人，需要额外帮助以保持水分充足。最重要的策略就是确保老年人摄入足够的液体（每24小时至少1.7升）。其他策略包括随时方便地提供健康饮品和水，并提醒和鼓励老年人饮用这些液体。不应鼓励老年人一次性大量饮水，而应在一天中少量多次饮用。如果由于某种原因无法实现推荐的液体摄入量，可以通过导管或皮下输液给予液体。在更特殊和严重的情况下，可以静脉输液。
老年人脱水的预防、警示和治疗是一项重要的多学科工作。正式和非正式护理人员需要持续关注老年人脱水的风险因素和体征，尤其是在天气非常炎热以及老年人患病期间。对高危患者进行标准的专业护理至关重要。
