Maintaining oral hydration in older adults: a systematic review

Dehydration is the most common fluid and electrolyte imbalance in older adults. The objectives were to identify the factors that increase the risk of dehydration in older adults, how best to assess the risk and manage oral fluid intake. Data sources included Medline, CINAHL, Cochrane Library, Embase and Current Contents, which were searched until February 2002. Randomized controlled trials for management of adequate fluid intake were undertaken. Cohort and case control studies were used for the identification of risk factors for dehydration. Studies of assessment tools for the identification of dehydration were also considered. Results show that there is no clear determination of the risk factors for dehydration and decreased fluid intake. The recommended daily intake of fluids should be not less than 1600 mL/24 h in order to ensure adequate hydration. A fluid intake sheet and urine specific gravity might be the best methods of monitoring daily fluid intake. Regular presentation of fluids to bedridden older adults can maintain adequate hydration status. In conclusion, more research is required to determine the optimum method of maintaining adequate oral hydration in older adults.