Detecting low-intake dehydration using bioelectrical impedance analysis in older adults in acute care settings: a systematic review

Background: Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal senescence, comorbidities, and polypharmacy. Detecting dehydration is key to instigating treatment to resolve the problem and prevent further adverse consequences; however, current approaches to diagnosis are unreliable and, as a result, under-detection remains a widespread problem. This systematic review sought to explore the value of bioelectrical impedance in detecting low-intake dehydration among older adults admitted to acute care settings. Methods: A literature search using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane Library was undertaken from inception till May 2022 and led to the eventual evaluation of four studies. Risk of bias was assessed using the Cochrane tool for observational studies; three studies had a high risk of bias, and one had a low risk. Data were extracted using systematic proofs. Due to insufficient reporting, the data were analysed using narrative synthesis. Results: One study showed that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. Other included studies supported the technique's utility when compared to conventional measures of hydration status. Conclusions: Given the scarcity of literature and inconsistency between findings, it is not possible to ascertain the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients.

Automated summary

The study found that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. While some studies supported the utility of the technique compared to conventional measures of hydration status, the scarcity of literature and inconsistency between findings make it difficult to determine the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients.