Dehydration Recognition in our Elders (DRIE) Diagnostic Accuracy and Cohort Study
Dehydration in older people is associated with risk of poor health outcomes such as falls, heart disease, confusion, pressure ulcers, poor wound healing, infections, drug toxicity, and poor quality of life. Early identification, prevention and treatment of dehydration in the community would be good for older people and reduce NHS costs. The most accurate measure of hydration requires a blood sample to assess serum osmolality. As this test is not commonly available in residential care, we are developing a simple tool (a short decision tree of tests) that could be carried out day to day by older people or their carers, that accurately indicates hydration status.
This research aims to improve health and wellbeing of older people living in residential care through:
1. identifying a method to identify early dehydration that can be used in residential care to, so that prevention and treatment strategies can be rapidly mobilised, and
2. clarifying associations between dehydration and health, functional status and quality of life in frail older adults.
The diagnostic accuracy study is complete. We recruited 200 older people living in residential care (where dehydration is common). At baseline we assessed participants for water-loss dehydration by measuring blood osmolality and promising markers of dehydration including: dryness of the mouth, presence of tongue furrows, cognitive status, body temperature, dry under-arm, urine colour and specific gravity, feeling tired, headachy or thirsty, missing drinks, body temperature, cognition, pulse, orthostatic hypotension, fingernail capillary refill and foot vein filling. In addition we collected health and demographic information.
We used this baseline data to assess diagnostic accuracy of each marker or test, then considered all the tests collectively to develop a 3-stage method (decision tree) to diagnose or rule out dehydration, with minimum testing. We are currently checking that this 3-stage method really works well, in our DRIE 2 study.
Cohort Study. We are visiting participants of the diagnostic accuracy study again at one and two years. We are collecting information on their wellbeing, health quality of life and functional abilities. This will allow us to assess the effects of dehydration in older people.
Who has assessed the ethical implications of the research?
The research has been checked and approved by the National Research Ethics Service Committee, London-East (11/LO/1997). More information about the National Research Ethics Service can be found here.
Publications, and other outputs
For the publications from this study, and other outputs, see the outputs page.
For more information
For an overview of the DRIE study download the study flow.
To read about the cohort study in greater detail download the DRIE protocol.
This is the information sheet about the cohort study (info sheet).
This is the more detailed DRIE participant info sheet.
This is a copy of the consent assessment and participant consent form.
DRIE is registered with the Research Register for Social Care ( http://www.researchregister.org.uk/) ID: 122273.