Dehydration in older people: A systematic review of the effects of dehydration on health outcomes, healthcare costs and cognitive performance

Caroline J Edmonds; Enrico Foglia; Paula Booth; Cynthia H Y Fu; Mark Gardner

doi:10.1016/j.archger.2021.104380

Dehydration in older people: A systematic review of the effects of dehydration on health outcomes, healthcare costs and cognitive performance

Arch Gerontol Geriatr. 2021 Jul-Aug:95:104380. doi: 10.1016/j.archger.2021.104380. Epub 2021 Feb 17.

Authors

Caroline J Edmonds¹, Enrico Foglia², Paula Booth², Cynthia H Y Fu³, Mark Gardner⁴

Affiliations

¹ School of Psychology, University of East London, Stratford Campus, Water Lane, London E15 4LZ, UK. Electronic address: c.edmonds@uel.ac.uk.
² School of Psychology, University of East London, Stratford Campus, Water Lane, London E15 4LZ, UK.
³ School of Psychology, University of East London, Stratford Campus, Water Lane, London E15 4LZ, UK; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.
⁴ Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK.

PMID: 33636649
DOI: 10.1016/j.archger.2021.104380

Abstract

Objective: To systematically examine the effect of dehydration on health outcomes, identify associated financial costs and consider impacts on cognitive performance in older adults.

Design: A systematic review of English-language articles via OVID using MEDLINE, PsychINFO, EMBASE, and others, to March 2018. Included studies examined the relationship between hydration status and health, care costs or cognitive outcome.

Setting: Cross sectional and cohort data from studies reporting on dehydration in older adults.

Participants: Adults aged 60 years and older.

Measurements: Independent quality ratings were assessed for all extracted articles.

Results: Of 1684 articles screened, 18 papers (N = 33,707) met inclusion criteria. Participants were recruited from hospital settings, medical long-term care centres and the community dwelling population. Data were synthesised using a narrative summary. Mortality rates were higher in dehydrated patients. Furthermore, health outcomes, including frailty, bradyarrhythmia, transient ischemic attacks, oral health and surgery recovery are linked to and worsened by dehydration. Length of hospital stay, either as a principal or secondary diagnosis, is greater in those with dehydration, compared to those who are euhydrated. Finally, neurocognitive functioning may be impacted by dehydration. There are issues with study design, inconsistency in hydration status measurement and different measures used for outcome assessment.

Conclusion: Dehydration in older people is associated with increased mortality, poorer course of illness and increased costs for health services. In addition, there is some, but sparse evidence that dehydration in older people is linked to poorer cognitive performance. Intervention studies should test strategies for reducing dehydration in older adults.

Keywords: Cognitive Performance; Dehydration; Healthcare; Older adults.

Publication types

Systematic Review

MeSH terms

Aged
Cognition
Cross-Sectional Studies
Dehydration*
Health Care Costs*
Humans
Middle Aged
Outcome Assessment, Health Care