IT PAYS TO KNOW: Aging Adults and Dehydration

By JUDD MATSUNAGA, Esq.

We all know the importance of staying hydrated. Water is your body’s principal chemical component and makes up about 50% to 70% of your body weight. Your body depends on water to survive. Water is essential to almost all bodily functions, from lubricating our joints to pumping blood to our heart.

According to the Mayo Clinic (www.mayoclinic.org), every cell, tissue and organ in your body needs water to work properly. For example, water: (1) Gets rid of wastes through urination, perspiration and bowel movements; (2) Keeps your temperature normal; (3) Lubricates and cushions joints; and (4) Protects sensitive tissues.

Normally, the body constantly gains fluid through what we eat and drink, and loses fluid through urination, sweating, and other bodily functions. But if we keep losing more fluid than we take in, we can become dehydrated. Dehydration means the body doesn’t have as much fluid within the cells and blood vessels as it should, bringing on health problems ranging from urinary tract infections to frequent falls.

Our bodies have a natural defense against dehydration – the feeling of thirst. If you start to become dehydrated, your body is designed to signal thirst in your brain. However, as we age, our body’s thirst signal diminishes. When your body needs water, you may not even realize it because you don’t feel thirsty like you once did.

Did you know that up to 40% of elderly people may be chronically under-hydrated? (2019 study from UCLA’s School of Nursing) Much like Alzheimer’s disease (33% of people over 85), if you have two friends, and they’re not dehydrated, chances are you are dehydrated. So it’s extremely important to stay hydrated, i.e., simply meaning that your body has enough fluids to function properly.

According to www.webmd.com, in addition to the diminished sense of thirst, seniors are more vulnerable to dehydration for a number of reasons:

(1) Body function. Older adults experience body composition changes over time that leave them with less water in their bodies to start with. Since your body has less water composition as you age, you become dehydrated much quicker than when you were younger. Your kidneys may not work as effectively with age, leading to a fluid imbalance in your body.

(2) Medications. Older adults are more likely to be taking medications that increase the risk of dehydration, such as diuretic medications, which are often prescribed to treat high blood pressure or heart failure. If you take a combination of several medications, be aware of interactions that may lead to dehydration.

(3) Cognitive impairment. If you suffer from dementia or Alzheimer’s, you’re at a greater risk for dehydration because you may not remember to drink when you need to. Even if your body sends thirst signals, decreased cognitive ability may mean your brain doesn’t understand the signals or it may miss them completely.

(4) Appetite and thirst tend to diminish with age. This means that even when your body is craving fluids, you might not be aware of it — and you may drink less than you need to stay healthy.

(5) Additionally — according to a recent study — older adults’ bodies don’t regulate temperature as efficiently as those of younger people. This means that during exercise or activity, seniors are more likely to become dehydrated through sweating.

Understanding the warning signs can help you take action before the situation becomes severe. The tiredness and lack of coordination that may result from dehydration can also lead to falls and injury. Even mild dehydration can cause an array of uncomfortable and debilitating symptoms. Early dehydration symptoms include:

– Dark-colored urine, urinating less frequently

– Fatigue, irritability, dizziness, headaches, confusion

– Muscle cramps in arms or legs

– Dry mouth

– Decreased cognitive function

According to gerontologist Leslie Kernisan, MD MPH, a simple preliminary check to see if an older adult is dehydrated is to check the color of your urine. If it’s pale in color and clear, you are likely well-hydrated. If it’s dark-colored with amber or brown tones, you may be dehydrated.

Another simple way to test if an older adult is dehydrated is to get the older person to drink some fluids. If drinking some fluids does noticeably improve things, that does suggest that the older person was mildly dehydrated. This often happens within 5-10 minutes. Although this is not the most accurate way to diagnose dehydration (i.e., laboratory testing of the blood), it’s easy to try.

The best way to prevent dehydration is the simplest: drink more water throughout the day.
“So just how much water should you drink each day?” According to the American Heart Association, the amount of water each person needs can vary. There are no single formula fits everyone.

Your individual water needs depend on many factors, including your size, health, how active you are and where you live. Knowing more about your body’s need for fluids will help you estimate how much water to drink each day. You’ve probably heard the advice to drink 8 glasses of water a day. For some people, fewer than eight glasses a day might be enough. But others might need more.

Sound confusing? You bet. I’ve got tall glasses and short glasses, thin glasses and fat glasses. Furthermore, I don’t think I even own a measuring cup. Dr. Kernisan says, “As a general rule, you should take one-third of your body weight and drink that number of ounces in fluids.” For example, if you weigh 150 lbs, one-third is 50 lbs. Drink 50 ounces of water each day.

To make things simple, a standard plastic water bottle contains 16.9 ounces. So, if you weigh 150 lbs and need to drink 50 ounces, you need to drink 3 standard water bottles each day (i.e., 16.9 x 3 = 50.7 ounces). However, as much you try, you might never be able to guzzle down three, perhaps four, bottles of water per day.

The good news is that it may not be necessary. About 20% of daily fluid intake usually comes from food (Source: Mayo Clinic). For example, many fruits and vegetables, such as watermelon and spinach, are almost 100% water by weight intake. In addition, beverages such as milk, juice and herbal teas are composed mostly of water. Even caffeinated drinks — such as coffee and soda — can contribute to your daily water intake.

Drinking pure, clean water is the best way to stay hydrated. But let’s face it – drinking plain water out of the faucet doesn’t taste very good. In that case, try getting a water pitcher with filter, e.g.,  Brita is the #1 water filter, which reduces chlorine (taste and odor), mercury, copper, zinc and cadmium for better-tasting water.

If drinking plain water all day gets boring, many experts suggest jazzing it up by adding slices of fresh lemon, apple, cucumber or berries. Remember that soda and sugary drinks are not good substitutes for water. If you love drinking these, though, remember to drop in a squirt of water or add some ice to your drinks, and you’ll eventually start to feel the difference.

Is water the only option for staying hydrated? No. You don’t need to rely only on water to meet your fluid needs. You may also choose to switch up water with other options such as low-sugar sports drinks or protein and nutritional shakes specifically designed for seniors. You can even try some carbonated water for some fun and filling bubbles. Coffee and tea can have a slight dehydrating effect, so they should not be counted toward your daily fluid intake.

Also, choose foods with high water content. If you have trouble drinking fluids, try including water-rich foods with every meal. These include cucumbers, watermelon, lettuce, strawberries, tomatoes and celery. Soups, broths and stews are also a good way to boost your fluid intake, especially in the colder weather.

If you’re watching your sodium, be sure to opt for low-sodium versions. Finally, avoid or reduce your alcohol intake. Alcohol is a diuretic, which means it prompts your body to remove fluids from your bloodstream. Limiting alcoholic beverages can help your body hang on to more of the water it needs to thrive.

In conclusion, if you’ve been experiencing dehydration, it’s best to talk to your doctor to determine how much water you should be drinking daily. They can review your medical history with you as well as any over-the-counter or prescription medications you’re currently taking. Certain medications cause the body to flush out more water. And some medical conditions, such as cystic fibrosis, also make people more prone to dehydration.

Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.