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July 23, 1997

Dehydration, Delirium, and Disability in Elderly Patients-Reply

Author Affiliations

National Institute on Aging Bethesda, Md
University of Tennessee Memphis

JAMA. 1997;278(4):287-288. doi:10.1001/jama.1997.03550040043023

In Reply.  —Dr Reyes-Ortiz brings to our attention the role that 2 classic geriatric syndromes, dehydration and delirium, may play in the development of disability in older persons. We were actually surprised by the finding in our study that nearly 3% of persons who developed progressive severe disability had dehydration listed as the first hospital discharge diagnosis in the year they became disabled. Indeed, we believe that what we found is only the tip of the iceberg and that the percentage of severely disabled older persons who are hospitalized for dehydration actually is much higher. While dehydration is often the factor that precipitates hospital admission,1 it usually is not well documented in medical charts, is occasionally misdiagnosed, and only seldom is indicated as the underlying cause of hospitalization in the discharge records.2 Dehydration is a common problem in older persons because the aging process is often accompanied by a misregulation