Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, Norfolk, UK.
Mech Ageing Dev. 2014 Mar-Apr;136-137:50-8. doi: 10.1016/j.mad.2013.11.009. Epub 2013 Dec 9.
This review defines water-loss and salt-loss dehydration. For older people serum osmolality appears the most appropriate gold standard for diagnosis of water-loss dehydration, but clear signs of early dehydration have not been developed. In older adults, lower muscle mass, reduced kidney function, physical and cognitive disabilities, blunted thirst, and polypharmacy all increase dehydration risk. Cross-sectional studies suggest a water-loss dehydration prevalence of 20-30% in this population. Water-loss dehydration is associated with higher mortality, morbidity and disability in older people, but evidence is still needed that this relationship is causal. There are a variety of ways we may be able to help older people reduce their risk of dehydration by recognising that they are not drinking enough, and being helped to drink more. Strategies to increase fluid intake in residential care homes include identifying and overcoming individual and institutional barriers to drinking, such as being worried about not reaching the toilet in time, physical inability to make or to reach drinks, and reduced social drinking and drinking pleasure. Research needs are discussed, some of which will be addressed by the FP7-funded NU-AGE (New dietary strategies addressing the specific needs of elderly population for a healthy ageing in Europe) trial.
本综述定义了水丢失和盐丢失性脱水。对于老年人，血清渗透压似乎是诊断水丢失性脱水的最适宜金标准，但尚未开发出早期脱水的明确迹象。在老年人中，肌肉量减少、肾功能下降、身体和认知障碍、口渴减弱以及多种药物治疗都会增加脱水的风险。横断面研究表明，该人群中存在 20-30%的水丢失性脱水患病率。水丢失性脱水与老年人的更高死亡率、发病率和残疾相关，但仍需要证据表明这种关系是因果关系。我们可以通过识别老年人没有喝足够的水，并帮助他们多喝水，来帮助他们降低脱水的风险。在养老院中增加液体摄入量的策略包括识别和克服个人和机构障碍，例如担心不能及时上厕所、身体无法取到或够到饮品、以及社交饮酒和饮酒乐趣减少。讨论了研究需求，其中一些将由 FP7 资助的 NU-AGE（在欧洲为老年人口提供健康老龄化的新饮食策略）试验来解决。
