Dehydration isn’t healthy for anyone, but it can be particularly concerning for older adults. “Dehydration can be dangerous for seniors, affecting their overall health and potentially worsening [medical] conditions,” explains Christopher Norman, a board-certified geriatric nurse practitioner with the National Council on Aging.
Not only can dehydration in seniors have serious impacts, but seniors are also more susceptible to becoming dehydrated due to underlying health conditions, life circumstances and other factors of aging, Norman adds.
If you’re a senior or care for one, hydration is something to pay attention to. Here, we’ll cover everything you need to know about dehydration in seniors, including how common it is, what the signs are and expert tips to help seniors stay hydrated and healthy.
Why is dehydration more common in seniors?
Proper hydration is essential for life. Our bodies are made up of about 60% water and fluids help to regulate temperature, waste removal, blood pressure, nutrient transportation and other vital processes. But a 2023 meta-analysis shows that 24% of non-hospitalized seniors experience insufficient fluid intake. That’s about 1 in 4 seniors.
So, why are seniors so susceptible to dehydration? “There are several factors as we age that make dehydration more common in seniors,” says Dr. Catherine Nicastri, a geriatrician at Stony Brook Medicine, including:
- A diminished thirst sensation, which can lead to less water intake.
- Medications for common medical conditions (hypertension, congestive heart failure, diabetes, constipation) that increase the risk of dehydration.
- Reduced mobility or swallowing issues.
- Urinary incontinence or urinary urgency that leads to limited fluid intake.
Signs of dehydration in seniors
Although it’s best not to let dehydration get to the point where it’s causing symptoms, the sooner you recognize the signs, the sooner you can address the issue. According to Norman and Nicastri, some common signs of dehydration in seniors are:
- Dry mouth.
- Dry skin.
- Fatigue.
- Dizziness.
- Infrequent urination.
- Reduced urine output.
- Dark colored urine.
- Strong urine odor.
Some dehydration symptoms in seniors can be more understated, Norman points out. “In seniors, less obvious symptoms like irritability, confusion or a worsening of chronic conditions can also mean they’re dehydrated,” he explains. “It’s important to pay attention to both physical and mental changes to detect dehydration early.”
“In seniors, less obvious symptoms like irritability, confusion or a worsening of chronic conditions can also mean they’re dehydrated.”
— Christopher Norman, board-certified geriatric nurse practitioner
Risks and impacts of dehydration for seniors
Dehydration isn’t just about being extra thirsty or feeling a little woozy. Dehydration can worsen current health conditions seniors have and even lead to new conditions. It can also increase accident risk and cause cognitive symptoms.
Here are the most serious impacts of dehydration in seniors, according to Nicastri:
- Cognitive impairment, such as confusion and delirium.
- Lower blood pressure, which can lead to lightheadedness; if blood pressure is severely low, it can cause the senior to pass out.
- Increased risk of falls and serious injuries, due to lightheadedness and weakness.
- Kidney damage or worsened pre-existing kidney disease (if dehydration is chronic).
- Urinary tract infections, because of more concentrated bacteria in the bladder.
- Constipation, which increases the risk of potential fecal impaction or bowel obstruction.
Electrolyte imbalances, which can cause muscle cramping and heart arrhythmia (a life threatening condition in seniors).
How to improve hydration for seniors
It’s imperative that seniors and their caregivers do everything in their power to prevent dehydration in the first place. Norman’s top suggestions include:
- Encourage seniors to carry a water bottle when out.
- Consume fluid-rich foods like fruits, vegetables and soup.
- Set reminders throughout the day to drink.
- Make fluid intake a regular part of a senior’s daily routine.
- Monitor hydration during hot weather and illness and encourage more fluid intake.
Norman also has advice for how to approach hydration for seniors. “I often encourage people to not ‘chug’ fluids quickly, but rather to sip at a drink throughout a day,” he describes. “If you have an 8-ounce glass of water and you’re watching a 30-minute TV program that has commercials, if you drink 1-2 swallows of the water on just the commercials then you’ll have the glass finished by the end of the show.”
In other words, keep water accessible throughout the day — on surfaces that are within reach, during daily activities and in portable water bottles when you go out — and encourage slow, but frequent intake to stay adequately hydrated.
“Signs of dehydration can be subtle and easily missed because the symptoms can be attributed mistakenly to ‘aging’ or other health conditions.”
— Dr. Catherine Nicastri, geriatrician at Stony Brook Medicine
When to seek help for dehydration symptoms in seniors
Anytime a senior shows signs of severe dehydration, you should seek immediate medical attention. As Nicastri notes, symptoms to watch for include:
- Confusion.
- Dizziness.
- Rapid heartbeat.
- Reduced urine output.
- An inability to urinate.
For seniors who are experiencing emergency symptoms, such as confusion, lightheadedness or reduced urine output, medical interventions may be necessary. “Treatment might include oral rehydration solutions or IV fluids, depending on how much they are dehydrated and the overall health of the senior,” Norman says.
Additionally, Nicastri says, “some medications may need to be adjusted when dehydrated and of course treating the underlying cause is crucial if due to an illness.” You should connect with your healthcare provider to get more detailed instructions on treating dehydration, based on your health status and current medical needs.
The bottom line
Dehydration in seniors is something to watch for and to take seriously. Don’t blow off symptoms if you see them, and take note of any unusual symptoms that may be related to dehydration, like new cognitive issues or confusion.
“Signs of dehydration can be subtle and easily missed because the symptoms can be attributed mistakenly to ‘aging’ or other health conditions,” Nicastri emphasizes.
If you have further questions about dehydration or how to prevent it, reach out to your healthcare provider.
