Summer is the time we often become more active out of doors. With increased outdoor activity and hotter temperatures there is a greater risk for dehydration-- even after only a couple of hours. Dehydration is a significant health risk, frequently intensified by age-related conditions including chronic diseases and related medications, less total body water, reduced kidney function, and the diminished ability to perceive thirst. This article highlights why good hydration is important and what you can do to support healthy aging.

Why stay hydrated and signs of dehydration

Water has many essential roles in the body like regulating body temperature, blood pressure maintenance, transporting nutrients, muscle function, helping rid the body of wastes, and lubricating joints. Not enough fluids can lead to dehydration, which can cause constipation, electrolyte imbalances, urinary tract infections, renal stones, kidney problems, and loss of balance. Severe dehydration requires immediate attention—see the signs and symptoms below.

An association between hydration and healthy aging

Hydration can also be important for healthy aging. A 2023 US National Institutes of Health study published in The Lancet documents adults who are well-hydrated may be healthier, develop fewer chronic conditions (like heart and lung disease), and live longer versus those who are not getting sufficient fluids. One study author commented “The results suggest that proper hydration may slow down aging and prolong a disease-free life.”

The overlap of nutrition and hydration

There is a complex relationship between nutrition and hydration, as various nutrients can influence fluid retention and electrolyte balance. As an example, a diet high in protein can increase renal load and fluid requirements, whereas sodium influences fluid retention. Fruits and vegetables are high in water content and can contribute significantly to hydration. These food sources are particularly critical because they provide both essential nutrients and fluids and may be easier for older adults to consume than drinking large volumes of liquid.

For older adults, overlapping risk factors can impact adequate nutrition and fluids, which can increase the likelihood of both malnutrition and dehydration. These overlapping risk factors are age-related and can include:

• Less muscle tissue and body water
• Chewing and swallowing problems
• Decreased functional abilities
• Decreased cognitive abilities
• Reduced social contact
• Limited offering of foods/beverages by caregivers.

Increasing fluids in the diet

The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends a daily water intake of 2.0 liters (over 8 cups) for older men and 1.6 liters (nearly 7 cups) for older women from all sources, including food. The US National Academies of Sciences, Engineering, and Medicine recommendations are even higher, 3.7 liters (over 15 cups) for men and 2.7 liters (over 11 cups) for women of daily water from all sources.

Here are several practical tips to help older adults increase their fluids and stay hydrated:

• Encourage regular fluid intake, including drinking fluids at each meal and between meals
• Offer more water throughout the day and urge older adults not to wait until they’re thirsty to drink—that’s too late
• Set a reminder on a phone or with a timer to help older adults remember to drink fluids
• Provide a variety of cold beverage options like fruit-infused water, fruit juices, herbal teas
• Offer an oral rehydration solution to help restore electrolyte balance and prevent dehydration
• Serve hydrating foods like fresh fruits and vegetables, including those with high water content such as cucumbers, lettuce, celery, tomatoes, oranges, strawberries, and watermelon
• Monitor high sodium diets which can promote dehydration and high blood pressure; consider reducing salt intake.

Educating to raise awareness

Hydration is a critical but often overlooked aspect of nutrition and health in older adults. Educate older adults, caregivers, and healthcare providers about the signs of dehydration/severe dehydration and the importance of regularly providing fluids/monitoring intake to improve patient outcomes and prevent dehydration. Maintaining hydration improves overall health, reduces risk for complications, and can support healthy aging.

Andie Lee Gonzalez, PhD, MPH, RDN, LD, FAND is a Medical Science Liaison for Pediatric Nutrition Scientific and Medical Affairs with the Abbott Nutrition Products Division of Abbott in Columbus, Ohio.

Check out this infographic and video that can be shared with older adults, caregivers, and staff