DEHYDRATION - EVALUATION AND MANAGEMENT IN OLDER ADULTS

Objective.-To review published literature regarding dehydration in old er individuals and formulate a consensus on the evaluation and treatme nt of this unrecognized cause of hospitalizations, morbidity, and mort ality. Data Sources and Study Selection.-The literature concerning deh ydration in the elderly population from MEDLINE was reviewed from 1976 through 1995. Search terms included dehydration, elderly, evaluation, hospitalization, and treatment, Particular emphasis was placed on art icles describing original research leading to the development of new i nformation on the evaluation and treatment of dehydration and review a rticles relating to the epidemiology, detection, treatment and health outcomes of this syndrome common in the geriatric population, includin g frail, institutionalized individuals. Data Extraction.-Data contribu ting to a broad scientific understanding of dehydration were initially grouped according to topic areas of the physiology of normal aging, i llness-associated clinical reports of dehydration in the elderly popul ation, and diagnostic and therapeutic interventions, The authors devel oped a consensus based on the weight of evidence presented and the aut hors' experience in the field. Conclusions.-Early diagnosis is sometim es difficult because the classical physical signs of dehydration may b e absent or misleading in an older patient. Many different etiologies place the elderly at particular risk. In patients identified as being at risk for possible dehydration, an interdisciplinary care plan with regard to prevention of clinically significant dehydration is critical if maximum benefit is to result.