Dehydratation verstehen – wie viel Wasser braucht der ältere Mensch?

Zusammenfassung

Als Exsikkose oder auch Dehydratation bezeichnet man ganz allgemein eine Symptomatik, die auf einen unphysiologisch niedrigen Wassergehalt des Organismus zurückzuführen ist. Aufgrund vieler im Alter häufigen Erkrankungen, aber auch vor dem Hintergrund des im Alter oft nachlassenden Durstgefühls, sind ältere Menschen besonders gefährdet, eine Dehydratation zu entwickeln. Die Symptomatik der Dehydratation geht nicht nur mit Schwäche und ggf. Verwirrtheit einher, sondern kann zu vielen Sekundärerkrankungen führen. Beispielsweise ist das Orthostasesyndrom, welches gehäuft zu Stürzen und Frakturen führt, meist durch eine Dehydratation bedingt. Die Diagnosestellung der Dehydratation ist gelegentlich schwierig, da keines der diagnostischen Zeichen über eine ausreichende Sensitivität und Spezifität verfügt. So kann die Diagnose meist nur aus der Gesamtschau des Patienten gestellt werden und durch eine erfolgreiche Therapie bestätigt werden. Für eine wirksame Prävention ist eine ausreichende tägliche Flüssigkeitszufuhr unumgänglich. Die 2018 veröffentlichte ESPEN-Leitlinie zur Klinischen Ernährung und Flüssigkeitsversorgung geriatrischer Patienten empfiehlt die Zufuhr von 1,6 und 2,0 Liter Getränken pro Tag für ältere Frauen und Männer.

Abstract

Dehydration is defined as any symptom or disease caused by a low fluid status. Older persons are at particular high risk because many diseases of older age put them at a higher risk and in general thirst is decreasing with advancing age. Typical symptoms of dehydration are weakness and disorientation, but dehydration may also lead to secondary diseases, such as falls and fractures due to orthostatic hypotension. The diagnosis of dehydration is not always easy to perform, because there is not a single sign with sufficient sensitivity and specificity. That is why the diagnosis mostly is obtained from the complete clinical picture of the patient and is supported by a successful therapy. For the prevention of dehydration, it is crucial to ensure a sufficient amount of daily fluid intake. The 2018 published ESPEN-guideline on Clinical Nutrition and Hydration in Geriatrics recommends the intake of 1.6 and 2.0 liter of beverages per day for older women and men, respectively.

Schlüsselwörter

Dehydratation - Ernährung - Exsikkose - Flüssigkeit - Geriatrie

Keywords

dehydration - fluid intake - nutrition - geriatrics

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