Symptoms Of Dehydration In Elderly

Symptoms Of Dehydration In Elderly
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More serious dehydration symptoms require immediate medical attention. These symptoms include:

The Causes and Symptoms of Dehydration in Older Adults

A senior woman in running gear drinks water from a sports bottle while on a trail in the park.

Dehydration happens when your body loses more fluids than it takes in.

Your body needs water for a variety of processes, including regulating your temperature, getting rid of wastes, and lubricating your joints.

Staying hydrated is particularly important as you get older. An older adult who’s dehydrated may be at a higher risk for complications like:

  • constipation
  • electrolyte imbalances
  • kidney problems
  • loss of balance

Read on to learn more about why older adults are more prone to dehydration, the symptoms to look out for, and what you can do to help prevent dehydration.

Older adults are more susceptible to dehydration for several reasons.

Dehydration risk factors in older adults

  • A decline in total body fluid. As we age, the amount of fluid in our bodies begins to decrease. This means there are fewer water reserves available for your body to use as you get older.
  • Lowered thirst response. Feeling thirsty is your body’s way of letting you know you need water. However, because the thirst response becomes weaker with age, older adults may not know they need to drink.
  • Decreased kidney function. The function of the kidneys can decline with age, meaning that more water may be lost through urination.
  • Health conditions and medications. Some older adults have underlying health conditions or take medications. In some cases, these conditions or meds can lead to an increase in water loss through urination.

Dehydration can have a variety of causes. Below are some of the most common causes of dehydration in older adults:

  • Heat exposure. Spending time in hot or humid conditions can lead to increased fluid loss through sweating.
  • Illness. Being sick with symptoms like fever, vomiting, or diarrhea can cause dehydration.
  • Mobility problems. It may be more difficult for older adults with mobility issues to be able to get water on their own.
  • Underlying health conditions. Some underlying health conditions, such as diabetes or kidney disease, can cause you to lose more fluid than normal.
  • Medications. A side effect of some medications may be increased urination, which can cause additional fluid loss. Some examples of medication that can cause increased urination include diuretics and certain blood pressure medications.

Some common signs and symptoms of dehydration include:

  • dry mouth
  • tiredness or fatigue
  • sunken eyes
  • a decrease in urination
  • urine that’s a darker color than normal
  • muscle cramping
  • feeling dizzy or lightheaded

More serious dehydration symptoms require immediate medical attention. These symptoms include:

  • a rapid heart rate
  • trouble with movement or walking
  • confusion or disorientation
  • fainting
  • diarrhea or vomiting that lasts longer than 24 hours

If dehydration isn’t treated, it can lead to serious complications, such as:

  • urinary and kidney problems, including urinary tract infections, kidney stones, and even kidney failure
  • seizures due to low levels of potassium and sodium
  • heat exhaustion or heatstroke
  • hypovolemic shock, a life threatening complication that causes a drop in blood pressure and oxygen levels due to low blood volume

Treatment for dehydration involves replacing the fluids that have been lost. For mild to moderate dehydration, this includes drinking water or other fluids, such as juices or broths.

Sometimes, vomiting or diarrhea can lead to a significant loss of electrolytes as well as water. In these situations, drinking beverages that contain electrolytes may be helpful. Examples include sports drinks and Pedialyte.

If dehydration is more severe, hospitalization may be needed. In this situation, fluids and electrolytes will be given intravenously.

If you’re an older adult, the following tips may help you stay well hydrated:

  • Try to drink water throughout the day. Other beverages that may also help with hydration include milk, flavored sparkling water, and fruit juices with low sugar. Drink coffee and tea sparingly, as they can have diuretic effects.
  • If it’s hard to drink too much liquid all at once, take small sips.
  • Try to include foods in your diet that have higher water content. Some examples include watermelon, cucumber, celery, strawberries, and low sodium broths or soups.
  • If you don’t find water very appealing, try adding a slice or squeeze of lemon or lime to add flavor.
  • Plan to drink more water if you’re going to be out in hot or humid conditions for a prolonged period of time, or if you’re going to be exercising.
  • If you’re ill with symptoms like fever, vomiting, or diarrhea, make sure to drink more fluids than normal.
  • If you have an underlying health condition, speak with your doctor about your specific fluid and hydration needs.

If you’re a caregiver for an older adult, you can do the following to help prevent dehydration:

  • Remind them to hydrate throughout the day, especially during mealtimes and after exercise or exertion.
  • Keep water in places where it’s accessible and easy to reach.
  • Implement easier access to the bathroom if they’re concerned about not making it to the toilet in time after drinking fluids.

Older adults are more susceptible to dehydration. There are many reasons for this, including lower fluid content in the body, decreased thirst response, and medications or underlying health conditions.

Recognizing the symptoms of dehydration is important so you can work to replace lost fluids. Look out for symptoms like dry mouth, fatigue, dark-colored urine, and lightheadedness.

Treating dehydration involves replacing lost fluids. You can work to prevent dehydration by making sure you regularly take in fluids throughout the day. This can include water, juices, broths, or foods with high water content.

If you’re unsure of your hydration needs, talk to your doctor to find out how much water you should be drinking each day.

Last medically reviewed on April 23, 2020

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Dehydration. (2019).
  • Drink up: Dehydration is an often overlooked health risk for seniors. (2018).
  • Fortes MB, et al. (2015). Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers. DOI:
  • Mayo Clinic Staff. (2019). Dehydration.
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8 Signs of Dehydration You Shouldn’t Ignore

From brain fog to muscle cramps, know the signals you may have waited a bit too long to drink up (and why it matters)

Dehydration may seem like something that happens to extreme athletes or someone who has a gastrointestinal illness. But doctors say dehydration is a very real risk for all adults over age 65.

As you get older, your sense of thirst is blunted, so you may not recognize your body’s need for fluids, says Ardeshir Hashmi, M.D., section chief of the Center for Geriatric Medicine at Cleveland Clinic.

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“On a warm or hot day, without even sensing it, you’re losing a ton of fluid,” he says. “In older adults, the same level of dehydration that normally triggers a thirst response may not. The thirst mechanism goes down drastically, especially after age 80.”

Other factors also put older adults at higher risk. The body’s ability to retain water in blood vessels decreases with age, so fluids are more easily depleted. If you suffer from diabetes or take diuretics, both can contribute to water loss.

What’s more, older adults with urinary incontinence may intentionally reduce their fluid intake or take medications to try to avoid accidents. And those experiencing cognitive decline may get dehydrated simply because they forget to drink, says Hal Atkinson, M.D., a professor of geriatric medicine at the Wake Forest School of Medicine.

Risks of dehydration — and how fever factors in

Unchecked, dehydration can have grave consequences, doctors say. It can cause confusion and weakness or prompt your blood pressure to drop so dramatically that you get dizzy, fall and break a bone. Or you can go into hypovolemic shock, when your blood pressure gets so low that your heart is unable to pump enough blood to the body.

“Water is life,” says Atkinson.“When you have too little fluid in the body, it can affect a lot of different organ systems, because your body is 60 percent fluid.”

It’s especially important to be on alert for dehydration if you or a loved one is sick. While most people know that diarrhea and vomiting cause fluid loss, you may not realize that a high fever is also a risk factor. In addition, some sedating medications can lead to dehydration because they reduce your body’s drive to drink.

So how can you tell if you or someone you care about is getting dehydrated? Here are the signs and symptoms to watch for:


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1. Thirst

If you feel thirsty, you’re probably already a bit dehydrated, especially if you are age 65 or older. “The amount of dehydration required for that sense of thirst to kick in is going to happen a lot later than when you were younger,” Hashmi explains.

Even if you don’t feel thirsty, older adults should drink throughout the day, he advises. Aim for at least 48 ounces of fluid (six 8-ounce glasses) a day – and more if you’re physically active. Juices, sports drinks, noncaffeinated sodas and flavored waters or seltzers all count toward your fluid intake, Hashmi says. You can also boost your intake with foods containing a lot of water such as soups, watermelon and cucumber.

2. Dark urine

The more fluid in your body, the clearer your urine will be. Your urine should be “almost the same color as tap water if you’re well hydrated,” Hashmi says.

If your urine turns a dark yellow or brownish color, or if it has a stronger odor than normal, that’s likely an early sign of dehydration, and you need to drink more water.

3. Dizziness or fainting

Although dizziness can be a symptom of many different conditions, it is a classic sign of dehydration, Atkinson says. When you’re dehydrated, you don’t have enough fluid in your blood vessels. You feel dizzy because “you’re not getting as much blood flow to the brain,” he explains.

You’re most likely to feel dizzy when you sit up after lying down, or stand up from sitting. If the blood flow to your brain drops significantly, you may notice a darkness in front of your eyes, Hashmi says. That may be a sign you’re about to pass out from dehydration.


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4. Muscle cramps or weakness

Another sign of dehydration is a feeling of weakness in certain muscles or severe muscle cramps. The cramps can be caused by electrolyte imbalances and reduced blood flow to those muscles.

Cramps can happen while you’re exercising, or you may wake up in the middle of the night with cramping in your calf muscles. “It can be severe enough that it won’t let you sleep,” Hashmi says.

5. Constipation or less frequent urination

Water helps flush toxins out of your body and keeps your digestive system running smoothly. If you’re adequately hydrating, you should be urinating every two or three hours and having regular bowel movements, Hashmi says. “If you’re not going to the bathroom the usual number of times, that can indicate a problem,” he says.

6. Dry skin or lack of skin elasticity

Dehydration causes skin to be dry and look sunken in some areas, such as under your eyes. Your skin will also have less elasticity than normal. If you are caring for someone who is frail, one way to tell if they are getting dehydrated is to gently pinch or press the skin on their arm. “When you touch their skin, it may not spring back as easily as before,” Atkinson says. “It can be very pronounced.”

7. Dry mouth

Dehydration also reduces saliva production. If you suspect someone is dehydrated, pay attention to the inside of their mouth, Atkinson says. “Their tongue should have a glisten to it,” he says. “In extreme (dehydration) cases, you may notice sores in their mouth that go along with not having enough fluid.”

8. Fatigue, headache or confusion

Low blood flow due to dehydration can cause a headache, tiredness and weakness. Or you may just feel a little less sharp than usual. If you’re a caregiver for someone who seems confused, don’t rule out dehydration as a cause, Hashmi says: “A lot of things can cause confusion; maybe mom or dad has an infection. But it could also be that they’re getting dehydrated, and their blood pressure has dropped. Sometimes when we give them fluid, it’s amazing what happens.”

Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation’s top consumer publications. Her work has appeared in Reader’s Digest, Real Simple, Prevention, The Washington Post and The New York Times.