Geriatric Syndrome
Dehydration is one of the most under-recognized and consequential conditions in older adults — driving falls, delirium, AKI, UTI misdiagnosis, and avoidable ED visits. Older adults are especially vulnerable because of blunted thirst, reduced renal concentrating ability, lower total body water, diuretic use, dysphagia, and cognitive impairment that limits independent fluid access. Clinical recognition is harder than in younger patients: classic signs like skin turgor and orthostasis are unreliable, and labs (BUN/Cr ratio, sodium, urine specific gravity) must be interpreted in context. This guide covers risk stratification, bedside assessment, oral rehydration strategies for patients who can swallow safely, hypodermoclysis for outpatient subcutaneous rehydration, and the disposition decision — when oral or SC fluids are sufficient versus when IV access and ED transfer are required.
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GERIATRIC SYNDROMES · NUTRITION
Risk assessment, clinical recognition, and management in older adults
AMDA dehydration guidelines 2023. For clinical reference only. Not a substitute for clinical judgment.
Last reviewed: 2026-04
Reviewed by the MyClinicianGuide editorial team. Cadence: annual.
Educational reference for licensed clinicians (NP, PA, MD, DO). Not a substitute for clinical judgment, institutional protocols, or specialty consultation. Apply in context of the full clinical picture, patient goals, and current standards of care. See About AI guidance for AI-related limitations.
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