Dehydration: How to spot it — and help prevent it

Your hydration needs change as you get older. Use these strategies to help ensure you’re getting enough H2O.

Joy Manning
Mature man drinking water.

Water is an essential nutrient, although you probably don’t think of it that way. Being well-hydrated allows you to feel your best and have the energy you need for the things you do in a day. Water affects every system of your body, the Centers for Disease Control and Prevention points out.

But once you get into your late 60s, your hydration needs change. At the same time, your sense of thirst isn’t as strong as it once was. That means it may not occur to you to finish the glass of water you poured for your meal. As you get older, you need to pay more attention to your daily fluid intake.

“For younger people, we talk about optimal hydration, but for older adults, we’re always talking about the very least amount of fluids they need to get by,” says Janet Mentes, Ph.D., a professor of nursing at UCLA School of Nursing. 

National surveys reveal that up to 40% of adults over age 65 may be chronically underhydrated, says Mentes. That puts them at risk for dehydration and its harmful consequences. In fact, according to the U.S. Department of Health and Human Services, this age group has the highest hospital admission rates for dehydration.

Here are some reasons why staying ahead of your thirst is so crucial, along with some simple strategies to increase your fluid intake. 

Why Older Adults Are Prone to Dehydration

Dehydration occurs when your body doesn’t have enough fluids to function properly, according to the Mayo Clinic. It can happen to anyone at any age, but several factors may increase the likelihood of dehydration in older adults. 

In addition to a lack of thirst, another normal part of the aging process is losing some of your muscle mass, a condition known as sarcopenia. As your muscle mass decreases, your dehydration risk goes up. That’s because muscles are like a storage tank for water molecules — they help keep an optimal balance of water in the body, Mentes says. 

Your kidneys can also lose some of their natural efficiency, leading to a greater loss of water when you pee. And there are many other age-related health conditions that can make you vulnerable to dehydration, says Melissa Prest, R.D.N., a spokesperson for the Academy of Nutrition and Dietetics. 

“People older than 65 are more likely to take a diuretic, for example. They’re also more likely to be managing type 2 diabetes or high blood sugar, which causes frequent urination,” says Prest.

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The Risks of Dehydration Are Real

You might not think much about the effects of dehydration, but a lack of liquid can have a big impact on your health. Here are some common consequences of dehydration in older adults.

Falls. Getting enough fluids can help keep you steady on your feet. “When older people are dehydrated, it can deplete blood volume and cause dizziness,” says Mentes. Dizziness may lead to loss of balance and, all too often, a tumble.

Infections. Dehydration can contribute to infections, especially urinary tract infections, says Mentes. If left unchecked, she adds, a urinary tract infection can cause sepsis and become deadly.

Heart problems. Even mild dehydration impacts cardiovascular function, a 2019 University of Delaware study suggests. “When you’re well hydrated, it’s easier for the heart to pump blood through the body,” says Prest. If your water intake is lacking, you might experience fluctuations in blood pressure or heart palpitations.

Are You Dehydrated? Watch for These Signs

Usually well before any of the above strikes, your body will send you little clues that you need more water, says Mentes. Your job is to pay attention. If you notice any of the following symptoms, increase your fluid intake. If the symptoms continue, call your doctor and ask about your next best steps.

Dry mouth. Even subtle dry mouth can signal the need to drink. This is a good guide for many people but, Mentes notes, some medications cause dry mouth as a side effect. If that’s your situation, dry mouth may not be your best indicator. 

Dizziness. Be alert for any hint of dizziness. “Dehydration can pull water from the cardiovascular system,” says Mentes, which can lead to lightheaded spells and falls. 

At the first sign of dizziness, sit down and ask someone to bring you some water. If you’re alone, wait until the dizzy spell passes and grab a glass of H20.

Urine color. You’re looking for a pale yellow shade. If it gets any darker, you probably aren’t well hydrated. Just keep in mind that some things, such as multivitamins, can cause your urine to change color.

Fewer bathroom breaks. You may not always be aware of your daily routines — including how many times you visit the bathroom. “If you’ve noticed that your urine production has gone down, that would also be a sign that you need more water,” says Mentes.

How Much Water Do You Need?

You’ve heard the traditional advice — drink eight glasses of water a day, or roughly 64 ounces. But is that right? Well, fluid needs vary a lot from person to person, so Mentes hesitates to provide a specific goal or guideline.

“I tell people that the amount of fluid they need to take in depends on age, size, body composition, activity level, what they’re eating, gender and many other factors,” she says. Most health care providers cannot tell you with authority exactly how much you should be drinking for your own optimal hydration, Mentes says.

So how do you work toward a goal of ideal hydration? Mentes suggests monitoring your fluid intake for a period of time. “A lot of people don’t think about it. They’re not thirsty, so they don’t drink much during the day,” she says. “Keeping track for three days can tell you a lot about your consumption.” 

Too vague? Mentes points out that the European Society for Clinical Nutrition and Metabolism guidelines for nutrition and hydration recommends 54 ounces a day for women and 68 ounces for men. The USDA doesn’t issue water intake guidelines for adults.

Your 8-Step Hydration Guide

Getting enough fluids in a day doesn’t happen automatically, but there are plenty of steps you can take to ensure you’re getting all you need. Try these strategies.

1. Don’t leave home without it. Get into the habit of carrying a water bottle. “Older people can’t always drink an 8- to 12-ounce glass of water rapidly, so it’s better to drink throughout the day,” says Mentes.

2. Set an alert. Sometimes — probably most of the time — you’re not going to feel thirsty. Set a reminder on your smartphone (a timer or alarm works, too) to take a water break once an hour. 

3. Wake up with water. Keep a glass of water by the bed and have a few sips right before you get out of bed in the morning. “If you finish dinner at 6 o’clock and that’s your last fluid for the day, and then you get up at 6 a.m., you’re going 12 hours without water,” says Mentes. 

4. Use an app. There are plenty of apps and fitness trackers that prompt you to log your fluid intake throughout the day, says Prest. This can be a great way to keep track. 

5. Don’t restrict. Often, older adults may avoid drinking water because they’re worried about urinary accidents, says Mentes. But this kind of self-restricting can lead to dehydration. Instead of going without, she suggests drinking smaller amounts of water more often.

6. “Eat” your water. About 25% of your fluid intake comes from food, says Prest. “Reach for water-rich foods like watermelon, cantaloupe, strawberries, celery and lettuce,” she says. Broth-based soups can also help you meet your hydration needs. 

7. Jazz up your H2O. Water is hands down your best hydration choice, says Prest. It’s sugar-free and calorie-free. But some people just aren’t excited about the taste. If you like flavored drinks, she suggests pouring two to four ounces of fruit juice into a glass and topping it off with water or unsweetened sparkling water. “It’s like a little spritzer,” she says.

8. Avoid caffeine and alcohol. Coffee has a diuretic effect, says Prest, and alcohol is dehydrating. Instead, pick other more hydrating beverages, like herbal tea.

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