Dehydration: evaluation and management in older adults
Article Abstract:
The American Medical Association's Council on Scientific Affairs recommends that more emphasis be placed on diagnosing and treating dehydration in the elderly. Dehydration is common in the elderly, especially those in a nursing home. Hospital discharge statistics indicate that 189,000 elderly patients were treated for dehydration in 1991, costing approximately $1,158,125,000. The elderly are at increased risk of dehydration because the aging kidneys cannot retain sodium and water as well. Dementia may reduce the consciousness of thirst and depression may alter fluid intake. One definition of dehydration is a loss of greater than 3% of body weight. Measuring various naturally-occurring ions in the blood can also reveal dehydration. Abnormal changes in blood pressure when changing position can also be helpful. Dehydrated patients should be given 1,500 to 2,500 milliliters of fluid daily and should be monitored for fluid overload.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
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Vitamin D deficiency in homebound elderly persons
Article Abstract:
Homebound, sunlight-deprived elderly people appear to be at risk for vitamin D deficiency. Researchers compared 116 people aged 65 and older who were confined indoors for at least six months to 128 healthy ambulatory elderly not confined. The confined group resided in community dwellings or in a nursing home. Eighty-three percent of the homebound elderly living in the community took in less than the recommended daily allowance for vitamin D compared to 36% of nursing home residents. Fifty-four percent of the community residents had serum levels of 25-OHD below 25 nmol/L, which is below the normal range compared to 38% of nursing home residents. Vitamin D supplementation may be useful in improving vitamin D levels in homebound elderly, who can be at greater risk for bone loss, weakness, and functional impairments.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
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A 96-year-old woman with insomnia
Article Abstract:
Insomnia in the elderly can have many causes and the treatment will depend on the cause. Most elderly people experience changes in the duration and quality of sleep. Their sleep time shortens, and they often take daytime naps. Short-term causes of insomnia include jet lag and work schedule changes. Long-term causes include medications, depression and concurrent illness. Insomnia in the elderly is often caused by chronic illness or medications. Sleep apnea and periodic leg movement disorder can also cause insomnia. Setting a regular pre-sleep routine can help elderly people get a good night's sleep.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1997
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