Hydration and dysphagia

Water is indispensable to life but there are times our bodies do not recognise the need for it. It is precisely at these times we need it the most.

WATER IN LIVING BEINGS
Water is one of the key nutrients for all living beings. It is said that it is possible to live for months without eating but not many days without drinking; this is because water plays an essential role in our bodies like regulating body temperature, solvent functions in chemical reactions as well as transporting and eliminating waste products.

With age the presence of water in the body changes and shrinks: in children it corresponds to 75% of body weight and in elderly people this percentage shrinks to 55%. Elderly people have less efficient “alarm systems” that are activated when the body needs water (dehydration) and induce defence mechanisms like feeling thirsty that replenish the body’s water supply. As a result it is our job to help the body to integrate the right amount of water!

NEED AND PREVALENCE
The water needs of an individual, defined as the quantity of water necessary to maintain intra and extra cellular homeostasis was established at 2.0 L/per day for women and 2.5 L/ per day for men (Source: EFSA). Studies have shown that around 6.7% of hospitalised patients over 65 suffer from dehydration and an even more alarming figure, among those with difficulty swallowing the prevalence of dehydration varies from 44% to 75%, depending on the criteria used to define dehydration.

DEHYDRATION IN ELDERLY DYSPHAGIC PATIENTS
The factors involved in dehydration in elderly patients are multiple: physiological changes (changes to the metabolism, a decreased sense of thirst ), causes linked to difficulty accessing drinks due to reduced mobility or confusion, causes linked to taking medicine and finally dysphagia. Dysphagia, in addition to being linked to malnutrition can contribute to serious and life-threatening dehydration. It is therefore important not only to quickly diagnose dehydration in dysphagic patients but also to prevent this condition through an appropriate nutrition assessment. Liquid foods and beverages are difficult to consume for dysphagic patients who often need alternatives to resolve this problem. Food for special medical purposes as thickeners and jellified water, are fundamental in this context.

Food for special medical purposes as thickeners and jellified water, are fundamental in this context.

SOURCES: Ferry, Monique. “Strategies for Ensuring Good Hydration in the Elderly.” Nutrition reviews 63. Supplement 1 (2005): 22–29. Web. Hooper, Lee et al. “Water-Loss Dehydration and Aging.” Mechanisms of ageing and development 136-137 (2014): 50–58. Web. Reber, Emilie et al. “Management of Dehydration in Patients Suffering Swallowing Difficulties.” Journal of clinical medicine 8.11 (2019): 1923–. Web