Development of a pre-dehydration assessment sheet: Research among elderly individuals who regularly visited an elderly-care institution

Abstract

Aim: In the present study, we defined the state of pre-dehydration (PD) as the suspected loss of body fluids, not accompanied by subjective symptoms, where the serum osmotic pressure ranges from 292 to 300 mOsm/kg・H2O. The goal of this study was to develop a PD assessment sheet based on the results of sensitivity and specificity testing among elderly individuals. Methods: We evaluated the serum osmotic pressure in 70 subjects >65 years of age who regularly visited an elderly-care institution. We then determined the associations between the serum osmotic pressure and various dehydration-related diagnostic factors identified in our previous study. Risk factors for dehydration were evaluated using a logistic regression analysis and allotted points according to the odds ratio. Results: PD was confirmed in 15 subjects (21.4%) using measurements of the serum osmotic pressure. We developed a PD assessment sheet that consisted of six items: ① Female gender (4 points), ② BMI≥25 kg/m2 (5 points), ③ Diuretics (6 points), ④ Laxatives (2 points), ⑤ Dry skin (2 points) and ⑥ A desire to consume cold drinks or foods (2 points). The cutoff value at which the risk of PD was high was set at 9 points (total of 21 points) (sensitivity 0.73, specificity 0.82; P<0.001). Conclusions: In this study, we found that 21.4% of the elderly subjects had PD. Using these data, we developed an effective noninvasive tool for detecting PD among elderly individuals.