Prevalence of low-intake dehydration in hospitalised older adults: systematic review and meta-analysis

Hooper, Lee, Parkinson, Ellice, Abdelhamid, Asmaa Saber, Deng, Ke, Edozie, Onyekwutozia, Fenner, Charlotte, Frost, Lydia, Ganeshamoorthy, Miruna, Mohandas, Saranya, Robson, Joseph, Shariff, Aisha, Wolmarans, Cameron and Bunn, Diane (2026) Prevalence of low-intake dehydration in hospitalised older adults: systematic review and meta-analysis. BMJ Public Health. ISSN 2753-4294 (In Press)

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Abstract

Introduction Low-intake dehydration is associated with higher mortality and poor health outcomes in older adults. Contributing factors (physiological, physical and cognitive decline, incontinence worries and reduced social drinking) may be exacerbated by illness, unfamiliar environment and routines in hospitalised older adults. We conducted a high-quality systematic review and meta-analysis to estimate dehydration prevalence amongst hospitalised adults (≥65 years) at admission. Methods We included studies of hospitalised participants measuring serum osmolality or osmolarity. MEDLINE, Embase, Cochrane CENTRAL, and CINAHL were searched (inception to July 2024). Inclusion, data extraction and risk of bias were assessed independently in duplicate. Data were described and synthesised in random effects meta-analysis (Meta-XL 5.3) and synthesis without meta-analysis (SWiM). Subgrouping assessed associations between dehydration prevalence and renal impairment, cognitive impairment, diabetic status, dependence, ethnicity, age, sex and economic status. Registration: PROSPERO CRD42021293763. Results Nineteen studies (of 13097 assessed) reported the most reliable low-intake dehydration measures (directly measured osmolality >300mOsm/kg, calculated osmolarity using Khajuria Krahn equation >300mmol/L). 14,398 hospitalised participants were included of whom 5039 (35%) were dehydrated at or near admission. While meta-analysis suggested 23% (95% CI 17-30%, GRADE moderate-quality evidence) were dehydrated, heterogeneity was high (I2 98%) and different meta-analytic models suggested higher prevalence. Likely prevalence was a quarter to a third of hospitalised older adults. Subgrouping was generally not feasible, but SWiM suggested higher prevalence may be associated with impaired cognition, diabetes, renal impairment, and perhaps higher dependency. Limited evidence suggested dehydration prevalence reduced only slightly during hospitalisation. Conclusions Between a quarter and a third of older adults have low-intake dehydration on hospital admission, varying with patient characteristics. Supporting older adults to drink well in hospital may be the appropriate response given high prevalence and severe health consequences. Trials are needed to assess effectiveness of in-hospital interventions to support drinking and improve health outcomes.

Item Type:	Article
Uncontrolled Keywords:	low-intake dehydration,aged,hospital,meta-analysis,prevalence,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Social Sciences > School of Global Development (formerly School of International Development) Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Medicine and Health Sciences > Research Groups > UEA Hydrate Group Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Social Sciences > Research Centres > Water Security Research Centre Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health)
Depositing User:	LivePure Connector
Date Deposited:	13 May 2026 14:10
Last Modified:	14 May 2026 15:16
URI:	https://ueaeprints.uea.ac.uk/id/eprint/103004
DOI:

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