Common Signs, Symptoms Do Not ID Dehydration in Seniors
None of the 49 commonly-used clinical signs, symptoms usefully discriminated those with dehydration
TUESDAY, March 12, 2019 (Pharmacist's Briefing) -- Many older care home residents are not being diagnosed with dehydration based on commonly-used signs and symptoms, according to a study published online March 11 in the Journal of Post-Acute and Long-Term Care Medicine.
Lee Hooper, Ph.D., from the University of East Anglia Norwich Medical School in the United Kingdom, and colleagues examined the diagnostic accuracy of commonly-used signs and symptoms of low-intake dehydration in older care home residents from 56 care homes. A total of 188 consecutively recruited care home residents aged ≥65 years without cardiac or renal failure and not receiving palliative care were recruited. Participants underwent double-blind assessment of 49 signs and symptoms of dehydration and measurement of serum osmolality from a venous blood sample over two hours.
The researchers found that none of the commonly-used clinical signs and symptoms usefully discriminated between participants with or without low-intake dehydration at either cutoff (sensitivity and specificity >70 percent for dichotomous tests; area under the receiver operating characteristic curve >0.7), although 20 percent of residents had current low-intake dehydration and 28 percent had impending dehydration.
"Further research is needed to develop and validate simple minimally-invasive assessments of low-intake dehydration in older adults to replace those currently used," the authors write. "In the absence of simple and valid tests, development of fully automated analyzers would make routine assessment of serum osmolality in clinical settings cheaper."