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Exploratory Study of the Prevalence of Major Chronic Disease According to Daily Water Intake and Physiological Parameters related to Dehydration in Korean Elderly: Based on the Sixth Korea National Health and Nutrition Examination Survey (2015)

한국 노인의 일일 수분섭취 상태에 따른 주요 만성질환 유병률 및 탈수 예측 생리적 지표 탐색 연구: 2015년 국민건강영양조사 결과를 바탕으로

  • Received : 2018.02.21
  • Accepted : 2018.04.09
  • Published : 2018.05.31

Abstract

Purpose: The aim of this study was to explore the prevalence of major chronic diseases related to daily oral water intake and to identify the physiological parameters related to dehydration in Korean elderly. Methods: The data were collected from the sixth Korea Health and Nutrition Examination Survey (KHANES), which was a nationwide and cross-sectional survey in 2015. We analyzed 1,392 participants using t-test and logistic regression. All participants were divided into the adequate water intake (AWI) group and the non-adequate water intake (NAWI) group based on the dietary reference intakes for Koreans. Results: There was a significant difference in the water intake between the AWI (6.8 cups in a day) and NAWI (2.8 cups) groups (p< .001). There was no statistically significant association between the level of water intake and any of the major chronic diseases. Blood urea nitrogen (BUN) and BUN/Creatinine (Cr) ratio were significantly higher in the NAWI group. Especially, BUN/Cr ratio shows that the NAWI group reached dehydration status. Older age (adjusted odd ratio, OR= 1.07, 95% confidence interval, CI [1.04-1.10]), female gender (adjusted OR= 1.56, 95% CI [1.05-2.33]), lower body mass index (BMI) (adjusted OR = 1.00, 95% CI [0.92-1.00]), higher BUN (adjusted OR = 1.04, 95% CI [1.01-1.08]), and higher urine specific gravity (USG) (adjusted OR= 1.56, 95% CI [1.19-2.05]) were factors associated with the NAWI group. Conclusion: The findings suggest that the level of water intake needs to be considered in relation to age, gender, BMI, BUN, and USG. These are sensitive physiological parameters used for predicting dehydration of the elderly according to their daily oral water intake. It would be helpful to develop strategies to prevent dehydration in elderly individuals and enhance their water intake.

Keywords

References

  1. Popkin BM, D'Anci KE, Rosenberg IH. Water, hydration, and health. Nutrition Reviews. 2010;68(8):439-458. https://doi.org/10.1111/j.1753-4887.2010.00304.x
  2. Thomas DR, Cote TR, Lawhorne L, Levenson SA, Rubenstein LZ, Smith DA, et al. Understanding clinical dehydration and its treatment. Journal of the American Medical Directors Association. 2008;9(5):292-301. https://doi.org/10.1016/j.jamda.2008.03.006
  3. Masento NA, Golightly M, Field DT, Butler LT, van Reekum CM. Effects of hydration status on cognitive performance and mood. British Journal of Nutrition. 2014;111(10):1841-1852. https://doi.org/10.1017/S0007114513004455
  4. Frangeskou M, Lopez-Valcarcel B, Serra-Majem L. Dehydration in the elderly: A review focused on economic burden. The Journal of Nutrition, Health & Aging. 2015;19(6): 619-627. https://doi.org/10.1007/s12603-015-0491-2
  5. Jang S, Cheon C, Jang BH, Park S, Oh SM, Shin YC, et al. Relationship between water intake and metabolic/heart diseases: Based on Korean national health and nutrition examination survey. Osong Public Health and Research Perspectives. 2016;7(5): 289-295. https://doi.org/10.1016/j.phrp.2016.08.007
  6. Wu LW, Chen WL, Liaw FY, Sun YS, Yang HF, Wang CC, et al. Association between fluid intake and kidney function, and survival outcomes analysis: A nationwide population-based study. BMJ Open. 2016;6(5):e010708. https://dx.doi.org/10.1136/bmjopen-2015-010708
  7. Oh H, Lee EH, Hur MH, Kim EK. The effect of fluid intake enhancing program for institutionalized elderly. Journal of Korean Gerontological Society. 2007;27(2):357-370.
  8. Kim M, Jung D. Development of evidence-based nursing practice guidelines for dehydration prevention of the elderly living in a care facility. Journal of Korean Gerontological Society. 2014;34(4):917-934.
  9. Lim JS, Jo HS. Effects of fluid therapy education program for aged stroke patients. Journal of Korean Biological Nursing Science. 2015;17(3):277-285. https://dx.doi.org/10.7586/jkbns.2015.17.3.277
  10. Leurs LJ, Schouten LJ, Goldbohm RA, van den Brandt PA. Total fluid and specific beverage intake and mortality due to IHD and stroke in the Netherlands Cohort Study. British Journal of Nutrition. 2010;104(8):1212-1221. https://dx.doi.org/10.1017/S0007114510001923
  11. Vecchis R, Baldi C, Cioppa C, Giasi A, Fusco A. Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Herz. 2016;41(1):63-75. https://dx.doi.org/10.1007/s00059-015-4345-9
  12. Sontrop JM, Dixon SN, Garg AX, Buendia-Jimenez I, Dohein O, Huang, SH, et al. Association between water intake, chronic kidney disease, and cardiovascular disease: A cross-sectional analysis of NHANES data. American Journal of Nephrology. 2013;37(5):434-442. https://doi.org/10.1159/000350377
  13. Thomas DR, Tariq SH, Makhdomm S, Haddad R, Moinuddin A. Physician misdiagnosis of dehydration in older adults. Journal of the American Medical Directors Association. 2004;5(2):251-254. https://doi.org/10.1016/S1525-8610(04)70088-2
  14. Stookey JD, Pieper CF, Cohen HJ. Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+ years. Public Health Nutrition. 2005;8(8):1275-1285. https://dx.doi.org/10.1079/PHN2005829
  15. Kim S, Kim CG, Hwang J, Jung D, Shin DS. Dehydration and its related factors among older adults admitted in a long-term care hospital. Korean Public Health Research. 2017;43(1):1-11.
  16. Kim SH, Lee M, Kang JH, Jeong SH. The effects of a fluid intake intervention for elders in long-term care hospitals. Journal of Korean Biological Nursing Science. 2012;14(2):139-146. https://doi.org/10.7586/jkbns.2012.14.2.139
  17. Bossingham MJ, Carnell NS, Campbell WW. Water balance, hydration status, and fat-free mass hydration in younger and older adults. The American Journal of Clinical Nutrition. 2005;81(6):1342-1350. https://doi.org/10.1093/ajcn/81.6.1342
  18. Marra MV, Simmons SF, Shotwell MS, Hudson A, Hollingsworth EK, Long E, et al. Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index. Journal of the Academy of Nutrition and Dietetics. 2016;116(5):828-836. https://doi.org/10.1016/j.jand.2015.12.011
  19. El-Sharkawy AM, Watson P, Neal KR, Ljungqvist O, Maughan RJ, Sahota O, et al. Hydration and outcome in older patients admitted to hospital (The HOOP prospective cohort study). Age and Ageing. 2015;44(6):943-947. https://doi.org/10.1093/ageing/afv119
  20. Vivanti A, Harvey K, Ash S, Battistutta D. Clinical assessment of dehydration in older people admitted to hospital: What are the strongest indicators? Archives of Gerontology and Geriatrics. 2008;47(3):340-355. https://doi.org/10.1016/j.archger.2007.08.016
  21. Jung HJ et al. Dietary references intakes for Koreans 2015. Final report. Sejong: Ministry of Health and Welfare & The Korean Nutrition Society; 2016 Nov. Report No.:11-1352000-001537-14.
  22. Fortes MB, Owen JA, Raymond-Barker P, Bishop C, Elghenzai S, Oliver SJ, et al. Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers. Journal of the American Medical Directors Association. 2015;16(3):221-228. https://doi.org/10.1016/j.jamda.2014.09.012
  23. Hooper L, Bunn D, Jimoh F O, Fairweather-Tait SJ. Water-loss dehydration and aging. Mechanisms of Ageing and Development. 2014;136-137:50-58. https://doi.org/10.1016/j.mad.2013.11.009
  24. Jequier E, Constant F. Water as an essential nutrient: The physiological basis of hydration. European Journal of Clinical Nutrition. 2010;64(2):115-123. https://doi.org/10.1038/ejcn.2009.111
  25. Jurgens CY, Goodlin S, Dolansky M, Ahmed A, Fonarow GC, Boxer R, et al. Heart failure management in skilled nursing facilities: A scientific statement from the American Heart Association and the Heart Failure Society of America. Journal of Cardiac Failure. 2015;21(4):263-299. https://doi.org/10.1016/j.cardfail.2015.02.007
  26. Ashraf MM, Rea R. Effect of dehydration on blood tests. Practical Diabetes. 2017;34(5):169-171. https://doi.org/10.1002/pdi.2111
  27. Holsworth RE Jr, Cho YI, Weidman J. Effect of hydration on whole blood viscosity in firefighters. Alternative Therapies in Health and Medicine. 2013;19(4):44-49.
  28. Lin CJ, Yang JT, Huang YC, Tsai YH, Lee MH, Lee M, et al. Favorable outcome of blood urea nitrogen/creatinine-based hydration therapy 3 months after acute ischemic stroke. The American Journal of Emergency Medicine. 2016;34(12):2414-2418. https://doi.org/10.1016/j.ajem.2016.09.033
  29. Lin LC, Lee JD, Hung YC, Chang CH, Yang JT. Bun/creatinine ratio-based hydration for preventing stroke-in-evolution after acute ischemic stroke. The American Journal of Emergency Medicine. 2014;32(7):709-712. https://doi.org/10.1016/j.ajem.2014.03.045
  30. Lin WC, Shih HM, Lin LC. Preliminary Prospective study to assess the effect of early blood urea nitrogen/creatinine ratio-based hydration therapy on poststroke infection rate and length of stay in acute ischemic stroke. Journal of Stroke and Cerebrovascular Diseases. 2015;24(12):2720-2727. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.08.002

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  1. Evaluation of Dietary Habit and Nutritional Intake of Korean Elderly: Data from Korea National Health and Nutrition Examination Survey 2013∼2015 vol.28, pp.4, 2018, https://doi.org/10.17495/easdl.2018.8.28.4.258