Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people

  • Lee Hooper, Asmaa Abdelhamid, Natalie J Attreed, Wayne W Campbell, Adam M Channell, Philippe Chassagne, Kennith R Culp, Stephen J Fletcher, Matthew B Fortes, Nigel Fuller, Phyllis M Gaspar, Daniel J Gilbert, Adam C Heathcote, Mohannad W Kafri, Fumiko Kajii, Gregor Lindner, Gary W Mack, Janet C Mentes, Paolo Merlani, Rowan A Needham, Marcel GM Olde Rikkert, Andreas Perren, James Powers, Sheila C Ranson, Patrick Ritz, Anne M Rowat, Fredrik Sjöstrand, Alexandra C Smith, Jodi JD Stookey, Nancy A Stotts, David R Thomas, Angela Vivanti, Bonnie J Wakefield, Nana Waldréus, Neil P Walsh, Sean Ward, John F Potter, Paul Hunter
  • Cochrane Database of Systematic Reviews, April 2015, Wiley
  • DOI: 10.1002/14651858.cd009647.pub2

What simple tests are accurate enough to help us to tell which older people are dehydrated?

What is it about?

Water-loss dehydration results from drinking too little fluid. It is common in older people and associated with increased risk of many health problems. We wanted to find out whether simple tests (like skin turgor, dry mouth, urine colour and bioelectrical impedance) can usefully tell us whether an older person (aged at least 65 years) is drinking enough.Within the review we assessed 67 different tests, but no tests were consistently useful in telling us whether older people are drinking enough, or are dehydrated. Some tests did appear useful in some studies, and these promising tests should be re-checked to see whether they are useful in specific older populations. There was sufficient evidence to suggest that some tests should not be used to indicate dehydration. Tests that should not be used include dry mouth, feeling thirsty, heart rate, urine colour, and urine volume.

Why is it important?

Many clinicians, health professionals and carers use simple tests to tell when frail older people are not drinking enough fluid (becoming dehydrated). But how accurate these tests are in older people has not been rigorously assessed before. This systematic review gathered all of the available existing research which can help us address this question, and found that no tests are clearly useful in telling us when older people are dehydrated. Some tests are promising and should be assessed in future studies.

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The following have contributed to this page: Dr Lee Hooper and Professor Paul R Hunter

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