When it comes to staying hydrated, seniors have it harder than most. Did you know, for instance, that older folks are more likely to have a broken thirst mechanism? They're also more likely to have mobility issues and take medications that impede hydration.
And those are just the tangible factors. The real problem is a lack of awareness and understanding of healthy hydration.
This has been quantified, believe it or not. In a community of 170 senior citizens, most folks reported drinking over six glasses of water per day, but very few understood the dangers of overhydration. They also overestimated the amount of fluid needed to prevent moderate-to-severe dehydration.
I'm not trying to pick on old folks; in many circles I already am “old” as I recently passed the half century milestone! Hydration illiteracy isn't an age-related problem, it’s a societal one. For decades, many of us have been relentlessly urged to “drink more water!” despite what our thirst dictates. Yet since seniors are more vulnerable physically, getting their approach to hydration wrong can mean a bigger hit to their quality of life and longevity.
Fortunately, getting it right isn't super complicated. Adding electrolytes to water can go a long way. And though most store-bought options are too high in sugar and too low in sodium, making electrolyte drinks for elderly folks is easier than you think. You can do it yourself with the salt shaker, or with a zero sugar drink mix like LMNT.
But I'm getting ahead of myself. We'll get to hydration tactics soon, but first, let's talk about dehydration, overhydration, and a common roadblock: the undeserved fear of salt.
Dehydration in the Elderly
Dehydration (net water loss from the body) is rare in healthy Americans. Why? Because most of us have easy access to fluids and a fully functional thirst mechanism.
Older folks may have fluids nearby, but they may have trouble with their hypothalamic thirst receptors, so they don't get thirsty when they should. Add this to the fact that seniors often take dehydrating medicines (like diuretics)—and that urinary and fecal incontinence are widespread—and I'm not surprised that between 17 to 28% of elderly folks suffer from dehydration.
The symptoms of dehydration include dark urine, dry skin, thirst, nausea, headaches, muscle cramps, and many more. See this article for a deep dive on dehydration in the elderly. Some of these symptoms (like dark urine) are relatively specific to dehydration, while others (like muscle cramps and headaches) can also stem from overhydration. I'll elaborate in the next section.
Because dehydration is more common in seniors, we make special efforts to get them enough H2O. (As you'll recall, the average senior in one community drinks over six glasses per day.) Unfortunately, drinking too much plain water can have terrible consequences.
Overhydration in the Elderly
To prevent dehydration, many people over-hydrate with plain water. They drink beyond thirst, shooting for eight or more glasses per day. The problem? Drinking too much fluid can dilute blood sodium levels and lead to a dangerous condition called hyponatremia.
Elite endurance athletes are “exhibit A” for hyponatremia borne of overhydration. When runners take in too much water, they often stumble across the finish line in a confused, light-sensitive, low sodium daze. In severe cases, hyponatremia can be fatal.
The symptoms of low sodium will likely be more subtle in Nana and Pops. They might complain of fatigue, headaches, muscle cramps, or low energy. And caretakers might blame dehydration, fill their glasses with water, and exacerbate the problem.
Remember, the data suggests that very few seniors understand the signs, symptoms, and significance of overhydration. It's not common knowledge.
And overhydration isn't the only cause of low sodium in the elderly. Other hyponatremia causes include:
- Heart failure
- Kidney failure
- Liver failure
- Diuretic usage
The overarching risk factor for these conditions? Age. So yes, older folks especially should dedicate special attention to their sodium status. And a core part of that is getting enough salt.
Overcoming the Fear of Salt
The war on salt has been going on for decades. In 1980, the American government published the first guidelines warning the public to avoid the salt shaker. Since then, it’s tightened up the messaging, urging us to limit sodium intake to 2.3 grams per day.
The case against salt is largely based on animal research from the 1960s. It turns out the rats from that research were salt-sensitive. Injecting them with unnaturally high doses of sodium caused hypertension. (Surprise, surprise.)
The human data tells a different story. For instance, the 1988 Intersalt Study found no correlation between sodium intake and the prevalence of high blood pressure in over 10,000 people across the globe. And other data from the Framingham Offspring Study shows that sodium restriction in line with government recommendations is linked to higher blood pressure on average.
Here's the thing. When you restrict sodium, you deprive your body of an essential mineral. Sodium regulates fluid balance, conducts nerve impulses, and more. Consequently, sodium deficiency is linked to muscular, neurological, and bone density issues.
Sodium is a critical nutrient, yet older folks may need help overcoming their fear of salt. (It contradicts what their doctor has told them since the Reagan administration.) Do what you can to get them on board. Share this article, send them research vindicating salt, and don't give up.
The Problems With Store-Bought Electrolyte Drinks
There are three main problems with store-bought electrolyte drinks:
- They contain too much sugar
- They contain artificial ingredients you don't want
- They don't contain enough electrolytes (especially sodium)
To my eye, sugar is the worst problem. Sugar-sweetened beverages (like sports drinks) comprise the main chunk of America's sugar intake. These empty calories are making us fat, metabolically imbalanced, and riddled with chronic disease.
And you know there's something inherently unhealthy about a product that turns your tongue red, blue, or purple. It’s best to avoid artificial colors whenever possible.
So why not buy electrolyte water at the store? These products are clear, pure, and don't contain sugar. But they also don't contain many electrolytes. Just a fairy dusting. Not enough to move the needle on sodium, potassium, magnesium, or other electrolytes. You might as well save your money and drink plain water.
What a Healthful Electrolyte Drink Looks Like
A healthful electrolyte drink should have zero sugar, zero artificial junk, and adequate amounts of the right electrolytes. The “right” electrolytes? Allow me to explain.
Sodium is the priority. It's the primary electrolyte lost through sweat and the primary electrolyte affected by overhydration. Your blood is salty, folks. Why would you only replace water?
It also makes sense to include potassium and magnesium. Most people are deficient in these minerals, and addressing these deficiencies can help with blood pressure, energy production, bone health, and more.
What about phosphorus and calcium? Get these minerals through diet. Most people consume enough (if not too much) phosphorus, and I’m seeing more research suggesting that calcium supplements increase the risk of heart disease.
So again, a healthful electrolyte drink shouldn’t contain sugar or other junk; just proper doses of sodium, potassium, and magnesium. This was our mantra when we created LMNT.
But that's just the "healthful" part of the equation. To keep seniors hydrated, you need them to consume electrolyte drinks habitually.
Helping Seniors Stay Salty and Hydrated
If you or your folks have spare time, you could make electrolyte homebrews with water, salt, potassium, magnesium, and a bit of lemon. That would be healthful, but it wouldn't be super convenient all the time.
To make a habit stick, the desired behavior should be both easy and attractive. (I'm borrowing this framework from James Clear's excellent book, Atomic Habits.) Some examples will help illustrate.
Make it easy. If you want to begin a meditation practice, start with 5 minutes of sitting. That's easier than attending a 10-day retreat where the most exciting part of your day consists of chewing tofu in silence while trying not to make eye contact with anyone.
Make it attractive. If you want to go for a jog every morning, reward yourself with a square of dark chocolate afterward. It makes the behavior more appealing.
The same logic applies to LMNT. The convenient stick packs are super easy to pack and use— just add to water and stir!—plus, they're super tasty.
Armed with LMNT, you should have a much easier time getting your folks to drink electrolyte water. They'll thank you later for helping them stay salty, hydrated, and energized.