Podcast – Thirst for Knowledge: Hydration & Dementia

Voice Over:

The Dementia Researcher podcast, talking careers, research, conference highlights, and so much more.

Dr Anna Volkmer:

Welcome to the Dementia Researcher podcast, bringing together early career researchers and leaders within the field to discuss their research, hot topics, and to share career tips. I’m Dr. Anna Volkmer. I’m an NIHR funded senior researcher in the Department of Language and Cognition at UCL, and also a speech and language therapist, and it’s my pleasure to be guest hosting today’s show.

Now, today we’re going to be discussing hydration, or more specifically dehydration, in older adults and people with dementia. Now, in my clinical days when I’m working as a speech and language therapist with people with dementia, I often spend time talking to people about eating and drinking. And some of our listeners may not realize this, but speech and language therapists often assess people’s swallowing to make sure everything is all going down the right way and to reduce the risk of chest infections and choking. So, in other words, I’m really looking forward to hosting today’s podcast so I can improve my own practice. So, without further ado, let’s meet our guests.

I’m delighted to be joined by four amazing guests. From the University of East Anglia, we have Ellice Parkinson, Amy Zile, Dr. Florence Jimoh, and from Age UK Norwich, we have Dan Skipper. Hello, everyone.

Ellice Parkinson:

Hello.

Dr Florence Jimoh:

Hello.

Dan Skipper:

Hello.

Amy Zile:

Hello.

Dr Anna Volkmer:

Now, why don’t we all introduce yourselves properly? So first of all, Ellice, do you want to tell us a little bit about yourself?

Ellice Parkinson:

Hello. So, I’m Ellice Parkinson. I’m a research associate and a PhD researcher at the University of East Anglia. I was previously a research fellow in the NHS in the field of Huntington’s disease, and now my PhD focuses on the hydration care of older people, and particularly people living with dementia in care homes.

Dr Anna Volkmer:

Wonderful, thank you. So, let’s move on to Amy. Can you tell us a bit about yourself, Amy?

Amy Zile:

Yep. So like Ellice, I am a PhD student at the UEA, although I am just about to finish. I’m also a senior research associate and a knowledge exchange associate working closely with Florence, Ellice, and the rest of the Hydrate Group at UEA.

Dr Anna Volkmer:

Gosh, you’ve got so many titles. That’s fantastic. Florence?

Dr Florence Jimoh:

All right. Hi, everyone. My name is Florence Jimoh, and I’m a senior research associate at the University of East Anglia, and I’m delighted to be here this evening. I think I joined the Hydrate Group, the UEA Hydrate Group in 2013, first as a voluntary researcher. So, I heard about this lovely research, and I thought, “Oh, okay, I think I want to learn a bit more about that.” I volunteered to help with dehydration… It’s called the DRIE study, Dehydration Recognition in Older Adults. And they were looking at how we can know if an older adult is actually dehydrated. And then following on that, I decided to complete an MRes semester in research, again on a hydration study in care homes, working with older adults that were residents, and eventually became a senior researcher and part of the Hydrate Group. I think prior to that, I became a lab-based researcher, so I’ve transitioned from lab-based into the people kind of research. And I’m also a trained teacher, science teacher.

Dr Anna Volkmer:

Oh, wow. Gosh, that’s amazing. So, is it your 10-year anniversary on the project?

Dr Florence Jimoh:

Yes.

Dr Anna Volkmer:

Is that? Yeah, my gosh, amazing. Happy 10 years.

Dr Florence Jimoh:

Thank you.

Dr Anna Volkmer:

And last of all, we’ve got Dan.

Dan Skipper:

I feel wholly inadequate after all that. So, I’m the chief executive of Age UK Norwich, so we’re a charity who help older people. And we’ve been working very closely with the UEA and the Norwich Institute for Healthy Aging for a number of years, and we had the opportunity to collaborate on this hydration project, which we know affects older people in many ways. So, it is very exciting for us to be involved and look forward to the conversation.

Dr Anna Volkmer:

Absolutely. Thank you very much for being here, all of you.

So first off, perhaps Ellice can give us a bit of an idea of the scale of this problem. How many people are actually dehydrated and why should people, specifically older people, care about drinking enough?

Ellice Parkinson:

Yeah, so that’s a really good question. So, we’ve just recently published in the Clinical Nutrition Journal a systematic review and meta-analysis, and we believe this is the first one that’s been done using robust measures of dehydration. And we have found that one in four older people are dehydrated, so that’s around the world. So, we included 61 studies, over 22,000 participants, and this spanned across 12 different countries. And so, from all of those, we then found, we used the most robust measure of dehydration in older people, which is directly measured serum/plasma osmolality because as we get older, other measures aren’t so effective so we can’t rely on those. So, this is the most robust measure, and we found that one in four older people are dehydrated. So that’s a really high percentage of older people who are dehydrated, so it’s a real problem.

So, what we found is that dehydration is prevalent, but it’s also preventable. So, we don’t have to put up with dehydration, we just need to drink more. So older people are more at risk of dehydration, and they may not know this. So sometimes we hear people say, “Well, I’ve never drunk a lot,” or “Oh, you know what, I’ve never really needed to drink much.” And I’m sure you’ve heard that in your work as well. And actually, what older people don’t always know is that as we age, we actually start to lose more bodily fluid. So, our kidneys aren’t as effective as they used to be so they don’t concentrate urine like they used to, might be taking antidiuretic medication which leads to fluid loss, things like, we have a reduced thirst sensation, so may not feel thirsty as much as we age. So, because of all those reasons, we do need to drink more than maybe our body needed earlier in life. So, we would recommend people drink at least two liters of fluids in a 24-hour period.

The health problems that come with dehydration are significant. So, there’s things like people having falls, which in older age people can take longer to recover from, headaches, dizziness, it’s linked to pressure sores, infections, pneumonia, UTIs, and then more serious health problems like diabetes, kidney problems, cognitive impairment. And then the most severe kind of health consequences which are associated with dehydration is things like increased risk of hospitalization and poorer outcomes if someone goes to hospital dehydrated, like longer length of stay, and also increased risk of dying in hospitals. So, these are certainly not things for us to shy away from. We really do need to encourage people to drink more.

Dr Anna Volkmer:

Absolutely. I didn’t hear you say delirium, and I know that’s always for me as a clinician in my clinical role, we talk loads about delirium in older adults. Would you put delirium in that category as well?

Ellice Parkinson:

Quite possibly. So, the evidence, anything with dehydration is based on kind of cross-sectional observational studies. So, there’s no causation linked with dehydration in anything, so these are just all links. What we do know is dehydration is linked to lots of problems, so it’s quite possibly a contributory factor. Delirium, as you know, is a really complex kind of condition anyway. So, what we know with drinking is there’s no harm in drinking, unless someone has a specific medical condition where they’ve been told they need to limit their fluid intake. We really do need people to get into healthy habits of drinking more.

Dr Anna Volkmer:

And so many older people will say they drink less because they’re worried about continence issues, aren’t they? And having to go to the loo overnight.

Ellice Parkinson:

It’s a real problem. But actually, the evidence is not strong for that. So, there are actually published findings which suggest that what people drink in the daytime does not actually affect that nighttime need to go to the toilet. So, there isn’t the evidence to back that up, but it’s certainly something we hear all the time in our work.

Dr Anna Volkmer:

Makes sense. Now, this might sound like an obvious question, and I’m going to direct this to Amy. Well, going back to what Ellice said, you’re talking about looking at serums to measure dehydration, but how would we know if an older person with dementia is dehydrated? And while you talk about this, I’m going to drink to demonstrate I’m not dehydrated.

Amy Zile:

Yeah, so as Ellice said, it can be quite tricky because the usual tests like skin turgor, where you pull on your skin and see if it pops back, don’t tend to work on older people because their skin’s a bit more wrinkly and tighter anyway. Even things that we might use like urine color, as Ellice said about the kidneys, they don’t work as much. Having a dry mouth could indicate loads of things. So, the best way is to do a blood test, but as we know, these can be difficult to do routinely. So, it is all about prevention.

Some people have said that headaches and confusions might be signs, which might be something that you’ve experienced, but there’s no real evidence to show that that’s a universal sign. It would make sense on a physiological level though, because when we get dehydrated it causes our tissues to shrink, which puts pressure on the nerves, particularly the ones in our head, and kind of pulls the brain away from the skull. So that can be really painful and cause headaches. And in terms of delirium and confusion, this might be due to lower water levels in the brain. Some people do complain of feeling a bit dizzy. But dehydration affects our cell metabolisms all across the body, which can lower our blood pressure and cause many other risks that Ellice mentioned, like pressure sores, hospitalizations, things like that.

So, the key thing to make sure an older person, particularly one with dementia, isn’t dehydrated is to try and prevent it by building in drinks throughout the day, keeping a log if you’re involved with the care of older adults, making sure that you know what they’ve been drinking. Because we do know that people with dementia might forget that they’ve had a drink or think that they have when they haven’t. So wherever possible, try to stay on top of it. And we know that drinking’s a really social activity. You know, you go round someone’s house for a cuppa, you bump into someone, you get a coffee, or you get a beer. So, trying to build in that social interaction will also help you keep track of how they’re doing cognitively, which you might then notice on a person-to-person level some of those warning signs that the evidence might not be there universally for.

Dr Anna Volkmer:

And it is hard to drink two liters of water, isn’t it? I mean I am guilty of not drinking two liters of water. I probably drink too many fizzy drinks instead, but I know they all count, but I probably don’t even drink enough fizzy drinks. But why might drinking, do you think, I know you mentioned dementia, but why might drinking be more difficult for someone with dementia or cognitive difficulties?

Amy Zile:

Although every type of fluid counts, aside from spirits, which we don’t encourage people to drink two liters of, there are misconceptions about it having to be water. And as a notorious water heater, if it were just water, there’s no way I could reach it. But it is about getting that fluid in, in as many different forms as you can. I know when it was really warm, you’ve got people with their ice lollies, and things like that can be a really good way to top it up. It can be difficult, particularly for people with dementia, if they don’t recognize that a cup or a glass that’s nearby them is to drink from, so often mirroring can be really useful. So, one of the things that we’re trying to encourage the Age UK health coaches to do is to take a drink with them and mirror, because they do a lot of mirroring in the exercises that they do.

If someone has difficulties such as swallowing, it’s really important to get them to someone like yourself, a speech and language therapist, who might be able to recommend things like thickeners, which could help them to maintain their hydration. And finding out what people like to drink. We found in our work that drinking was a lot easier when people were doing it out of their favorite cup. They knew how much was in it, they knew where it came from, they were comfortable holding it, they felt like they wouldn’t spill it. Or for some people, it’s about having a water bottle with sort of a sucky straw to make sure that they’re not spilling things and that they’re able to hold it, particularly if they’re shaking and they don’t want to hit their teeth. And trying to make drinking fun wherever possible. It doesn’t have to be water; it doesn’t have to be sort of boring. It could be old-fashioned cloudy lemonade, it could be Bovril, it could be anything that older people like to drink. It’s just about trying to get the fluid into them as much as possible.

Dr Anna Volkmer:

That’s such a comprehensive list of strategies. And you’re right, I do sometimes as a speech and language therapist recommend thickener, sometimes. And for the listeners, thickener is a powder that we put in drinks to… Sometimes it can help people who have swallowing difficulties get things down the right way. But I have to say, we really treat it as a short-term option because, in my clinical experience, a lot of people find they drink less, actually. And there is some research that supports that, that people who have thickener in their drinks drink less. And people say to me, “Oh, I don’t like the taste, I don’t like the flavor.” So, Florence, are there any more things we can do to improve drinking and prevent dehydration in older people and people with dementia?

Dr Florence Jimoh:

Thank you, Anna. I believe improving or preventing dehydration will look different for each of our older adults. Again, it depends on where they’re living, and it depends again on their level of independence. If someone can actually look after themselves, the way you will talk about hydration with them will be different from people living in care homes that are really dependent on their carers to support them, to serve them the drinks or to take them to the loo if they need to. So, the worries are different. And I think the context is kind of different, but I think generally we have top tips that we believe could help each of these older adults.

I think Amy did point out the key one and it’s offering them their favorite drink. Nothing beats that. Offer them what they like because they will drink it. It could be in their favorite mug, it could be in their favorite cup, or something they really like. Make it the way they like it because before these people… Actually, for those living in care homes, before they move into care homes, that’s the way they make their tea. That’s the way they make their coffee. So, we say, if they’re still able, why make it for them? Why not involve them? It is now their home. They have moved away from home into a home. We call it care home for a reason. It is their home. Make sure you find out how they like it or support them to make it the way they like it. So, if people have the drinks that they like, they will drink.

One of the things I did when I was working on my Mres was to actually just stay in the care home from morning to nighttime, and I followed different people all through the day, from when they woke up to when they went to bed. I look at what they are drinking, where they drink it. And we found out that when people are offered drinks like squash, they will just leave it, half cup there, one quarter cup there. But when we offer them things like apple juice, all gone, orange juice, all gone. We say, why don’t you give them what they like to drink? And sometimes when the tea trolley goes round, by the time you move from one point of the care home to the other, it’s already cold. How do you expect them to drink that?

For people with dementia, why leave them in the room when, like Amy said, they can actually forget that there’s a cup beside them? When you bring them out, we had social activities with them where everyone is in the living space, and they mirror each other. So, they see you have the drink and then they’re having the drink as well. We had different activities where people actually tried different drinks out. So, it’s not just tea. We had a tea tasting session where people had maybe strawberry tea, flavored tea, lemon flavor tea, and people had different ideas of what else they could actually drink. So favorite drink is one thing that will help people to drink well.

The other thing we also found is that there is nothing like offering as often as possible. If they’re not offered, they’re not likely to take it. Even if you are living in the community, if you have people around you that can offer you drinks, very, very good. And because drinking is a social thing, isn’t it? So, you have a visitor, the first thing you want to do is, “Oh, I’ll put it on the kettle.” So, we’re saying, why not put on the kettle and have a drink with people? Because now they’re limited in where they go to and how they can go about things.

I think apart from that, one other thing we found is that offering a drink or encouraging people to have drinks before, during and after breakfast is really important. I mean, most older adults will go to bed quite early. So, imagine someone that has gone to bed from 8:00 PM up till about 7:00 AM the following morning, they’ve been away from drink for 11 hours. That is a long time without any sort of fluid. So, whether people are living at home or in the care home, if you can get in [inaudible] in the morning, stroke afternoon, worry about toilet is not as much as when you start getting towards the evening. So, if you can get the drinks early in the morning and afternoon in between meals, with meals, it’s really, really great. And with dementia, I think if they can set up reminders, that will also be good.

And in terms of preventing dehydration, I mean, Ellice did say that it’s a big problem, but the best way to prevent it is to actually encourage people to drink. That is the key thing. Just encourage them to drink. And you think it’s quite easy to encourage people to drink. It’s actually not that straightforward. So, you have to kind of think of what it is that will help them or attract them to drink.

Finally, I want to say that even though dehydration is a big thing, I think we’re not paying enough attention to it. I think there needs to be a drive for health promotion regarding hydration, like any other thing. It’s something that is so simple, yet it’s really costing us a lot with all the things that are associated with it. So, we need to, the government, everybody needs to push this. We need to increase the agenda and promote it as a health issue that needs attention. People need to know the benefit. I mean, with the Age UK project that we have been involved in, all the adults say, “Oh, I didn’t know that would help me. I didn’t know the hydration could do this for me.” And when we go back, because most of them we have gone back to see them twice, Amy would actually confirm this. The second time we visit them, they offer us drink once we get into their home. They’re saying, “I’ve got a new cup. I’ve got a new bottle now.” So, they just need to understand the importance. They also need to know the consequences. “If I don’t drink enough, this is it.” And with that understanding, people choose to drink more.

Dr Anna Volkmer:

That makes sense. And also, I guess what I’m hearing as well, Florence, is that it’s not just about the person, it’s about the people around the person.

Dr Florence Jimoh:

Yes. So, healthcare professionals.

Dr Anna Volkmer:

Yeah, exactly.

Dr Florence Jimoh:

Carers. Friends. Family members. All of us.

Dr Anna Volkmer:

Exactly. All of them. And how do you change their behavior, though? How do you get them to encourage the person? That would be my, I guess, another question. Because so often I work with families and they say, “Oh, well, it’s the person, because they just don’t drink it.” And I spend time saying, “Oh, well, you need to work with the person. And you need… It’s partly on the… You need to do something.” And actually, it can be as hard to get the people around the person to change what they’re doing. Is that fair, Florence?

Dr Florence Jimoh:

I will say yes and no. I believe that when people are educated, they make informed decisions.

Dr Anna Volkmer:

Yeah.

Dr Florence Jimoh:

So, some of these carers, family members, also don’t drink well enough and they don’t understand how hydration could be of benefit to them. And sometimes they don’t even know what their loved ones will like best. We know that with dementia, I think, at least I’m not an expert in that, but I do hear that sometimes with dementia, there’s a change to the taste bud. So, what people liked before, they don’t like it anymore, and it’s left to the family members, it’s left to carers, to find out what else this person can actually have.

One of the people we went to visit, I mean, in our Age UK project, the wife just kept going on about of, “Oh, how he loves to drink coffee all the time.” And this is a guy that has just been out of hospital with stroke, he’s just recovering. So, communication wasn’t really a lot, he could just mutter a few words. But when we showed him pictures, we had this drink menu, one of the things we made as a resource for older adults living in community, and we’re showing him pictures of different hot drinks and cold drinks. He was really keen on one. And we said, “Which one?” He said, “Horlicks, Horlicks, Horlicks!” The wife said, “Horlicks?” He said, “Yes, I would like Horlicks.” And so, she said, “Oh, hydration people, now they’re going to make me go shopping for my husband for Horlicks.” But it shows that he’s had it before, he loves it, but maybe a long time ago, she didn’t even know. And I mean, these are people that have been together for, I mean, maybe 30, 40 years. And the husband is, she’s getting to know something different about him.

So, I think it’s about education, I think it’s about exposure, I think it’s about promotion, and I think it’s about everybody being responsible and being active, not passive. When they’re active as carers or healthcare professionals, they will go the extra length to find out what will make a difference. We found this in our care home studies, honestly. And we know that it can also do the same for community older adults.

Dr Anna Volkmer:

And your comment, I’ve experienced that a lot where people say to me, “But he used to love curries, and he used to love…” Or “He used to hate curries and he used to hate sweet things. He used to hate them. So, I don’t give them to him, because he won’t like them.” And then the person will go to a day center or be in a residential facility and he’ll be eating really strong flavored curries and drinking the sweetest things in the world. And that can be quite surprising to the carers and family members. And I often spend time… So, with my speech therapy hat on, there is some research that’s out there that kind of suggests that stronger flavors can really stimulate a swallow better. So, things like, so I often say to people, a sweet flavor in a drink or a sour flavor in a drink can be more stimulating than just water. And then family members see that actually, the person is able to drink more efficiently.

So, we often recommend stronger flavors as a way of providing more semantic information to trigger the swallow more strongly. But that can be really difficult for people to take on board, as you’re saying, Florence, because of their perception of the person as a person and their likes and dislikes. It’s tricky, isn’t it? But I find it really useful to think about motivation. You’re right. If people are informed, understand, and going right back around to what Ellice said at the beginning, I mean, I didn’t know that our body, I don’t know, digests water differently or doesn’t retain water in the same way. I didn’t know that.

Ellice Parkinson:

And I didn’t before my PhD. I had no idea about the importance of drinking, the importance of dehydration. And it goes back to what Florence is saying, is we need to get that information out there. And that’s what we are doing with collaboratively designed posters to raise awareness of this one in four risks of dehydration to older people, which will go to about 400 health and social care sites in Norfolk and Waveney, and hopefully NHS digital, as long as… I’ve been able to contact them, and they’ve referred on to the Department of Health and Social Care Minister, MP [inaudible], to hopefully take that forward across the UK. Because that was the feedback from our older people in the workshops, is they’re not going to benefit from these posters, and they really feel that this needs to be out there and raise awareness of it to healthcare professionals and social care professionals as well as the general public.

Dr Anna Volkmer:

Absolutely.

Amy Zile:

And I think…

Dr Anna Volkmer:

Go on, Amy.

Amy Zile:

… going back to, as Ellice just said, but also as Florence said, yes, this is a big issue for older people, but it’s just a general public health issue. And one of the ways that we got sort of a buy-in from an older adult was that he said that he was going to speak to his son about that we’d been round and seen him, and then the next time we went round it was, “Well, I’ve got this bottle and my son’s got his bottle and we’ve set each other the goal of finishing it each day.” So, it’s not necessarily about getting the people around the older person to tell them what to do, it’s about doing it together, doing it as a lifestyle change, rather than telling them what to do. Because that was something that we had from a number of older men that we saw, was that “My wife’s always telling me…” But when they were doing it together and it was something that was more collaborative and fun, there’s a lot more buy-in from people. And then obviously, you’re preparing the younger generations to incorporate hydration, which can hopefully prevent dehydration when they get older.

Dr Anna Volkmer:

Absolutely. And I think that’s a great idea to also promote it to all the health professionals, nursing staff, care staff, allied health. I’m sure that that information would sit really well within their repertoire of information sharing. I talk about eating and drinking quite a lot with people, and that could be a fact I could easily insert into the health education that we provide. So, I’m sure that that could be something we could use. And Dan, I know you’ve been doing lots of work in your role in this partnership between Age UK Norwich and the University of East Anglia. And is part of that… Now, I want to know how your relationship came about, but I wondered, is part of your role about promotion as well? Sorry, I’ve asked you two questions, how mean of me.

Dan Skipper:

Yeah, so a number of years ago, we introduced health coaching as part of our service range. And that was generally from so many clients referred to us who were not physically able to participate in community activities because of their health. So, the system around them, GPs, hospital, would just very simply make a referral to the community. That’s where all the solutions were. But if you’ve just come out of hospital and you’ve just had hip surgery, you functionally cannot sometimes even get out of the chair, let alone go to the community center and things like that. So, we have physical health instructors who support people one-on-one, often taking, if you like, step down instruction from physiotherapists, OTs, to progress that into the home to make sure people are doing the exercises safely.

And then obviously, that then broadened into partnerships with the UEA around the Norwich Institute for Healthy Aging, evaluating the impact of our coaching on physical health levels. And then that’s then developed, as you can naturally understand, into [inaudible], and then this hydration project was something that we looked to collaborate on. But a lot of the clients we see are fresh out of either health or social care situations or living on their own. And I think one thing not been touched on today is the impact of loneliness. And there very well may not be lots of research around this, but those social scenarios where people may be offered a drink, maybe they’re mirroring, when you’re living on your own and not exposed to that, that’s bound to be part of the picture. So yeah, we’re very keen to look at all things health as an organization, we are trying to make Norwich an age-friendly city and taking the World Health Organization age-friendly communities’ principle forward. And a big part of that is about health and independence and living as an active age and a healthy aging as you can be.

And as Amy touched on, that starts well ahead of your later life. And we can see from population data how actually we’ve got a population who’s never been as unwell as we have, and we’ve got some big changes to make. And hydration is an area we can prevent, and associations with dementia and physical fitness and things like that. I think we do have to put more effort into how we can solve things that can be solved now. And a good example, when I go to my dentist, there’s a water cooler in the corner of the room and they encourage you to drink. But if I go to my GP practice, there isn’t one. So, there’s systematic things around the environment, as well as that one-to-one stuff around helping people make the right decisions.

Dr Anna Volkmer:

You know, we have a water cooler in our outpatient department. But nobody takes a drink because nobody knows it’s a water cooler. And it looks like it’s only for staff members, but it’s not. It’s like this mysterious machine. So, I hear what you’re saying, I think there needs to be stuff done, doesn’t there? To kind of really advocate for and promote this in all environments. Yeah, I completely see that. But it’s so interesting how you’re involved in this, Dan. I feel like I might need to have a conversation with you after this podcast because there’s so much work to be done between what happens with the health and social care workers and what happens to people in real life.

Dan Skipper:

Yes. And I think there’s a very, very big gap between what happens in the health space versus what happens in the care space. And actually, the bubble of the population is ultimately living on their own without either support sometimes. And I think there’s also the wider determinants of health around, just because we’ve got an older population doesn’t mean that they’re misusing alcohol, doesn’t mean they’re misusing drugs, doesn’t mean that they’re overprescribed. So, there’s other factors that can really impact on health and wellbeing. And I think I’d absolutely love to see our screening programs, especially maybe 40 plus, start picking up wider determinants of health. And we should include things like hydration, should include things like loneliness and looking at where you live, the impact of your relationships, because they have a tradeoff to your wellbeing and your health. So, I think we need to get… The research shows all these things, but they’re not in practice yet.

But through this project, I really hope I’ll be using my Age UK network to get this shared across there. And also, the things I’m involved with, the integrated care system about hospital discharge, about supporting people who are living with dementia and other conditions. And I think one key area is recovery. We’ve got a lot of people who have comorbidities, they’re going in and out of hospital, and things like hydration, eating well, are absolutely critical to their recovery. But then they’re sort of assumed, but we have to work really hard to make sure they’re there, they’re fundamentally part of their recovery.

Dr Anna Volkmer:

Thank you all for raising that here, because I think this is a really great forum to raise this with other researchers and anyone listening to these podcasts. So, thank you all for working, not only today on the podcast, but working more broadly to raise the profile of this issue. So, I’m going to recap a little bit on the takeaways from today’s show, which are essentially, probably the headline is, Drink More. And I guess what we’ve been talking about is that older people often don’t drink enough. In fact, the level of dehydration is really significant amongst older people. And actually, there are huge health risks, in fact, more so amongst older people. And we know that older people might be more at risk of not drinking for lots of different reasons, including cognitive issues, including loneliness, including misconceptions like not drinking too late at night. And actually, there’s lots of things that they and we can do as a community to support people and ourselves to drink more. And perhaps a really useful strategy is to become more informed because I think knowing the risks of dehydration can help people understand why to avoid it. I think that’s the key message from today, isn’t it?

So, I’m afraid that is all that we have time for today. And if you just can’t get enough on this topic, visit the Dementia Researcher website where you will find a full transcript, biographies on all our guests, blogs, and lots and lots more on this topic. And I’d like to thank our incredible guests, Ellice, Amy, Florence, and Dan. Thank you everybody for being here today.

Dr Florence Jimoh:

Thank you.

Ellice Parkinson:

Thank you.

Dr Anna Volkmer:

No, thank you.

Dan Skipper:

Thank you.

Amy Zile:

Thank you.

Dr Anna Volkmer:

I’m Dr. Anna Volkmer and you have been listening to the Dementia Researcher podcast. Bye, everybody.

Ellice Parkinson:

Bye.

Dr Florence Jimoh:

Bye.

Amy Zile:

Bye.

Voice Over:

The Dementia Researcher podcast was brought to you by University College London with generous funding from the UK National Institute for Health Research, Alzheimer’s Research UK, Alzheimer’s Society, Alzheimer’s Association, and Race Against Dementia. Please subscribe, leave us a review, and register on our website for full access to all our great resources, dementiaresearcher.nihr.ac.uk.

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