The physical signs of impending dehydration among elderly people in nursing homes: The association with axillary skin temperature, humidity, intraoral moisture content, and salivary components

Purpose: The aim of the present study was to examine the association between impending dehydration among elderly people in nursing homes and physical signs, including the axillary skin temperature, humidity, intraoral moisture content, and salivary components. Methods: The study included 78 elderly individuals who required long-term care in a nursing home (11 men and 67 women; average age, 86.6±7.3 years). The elderly subjects were classified in two groups according to their serum osmolality levels: those with levels between the upper limit reference value (292 mOsm/kg H2O) and the diagnostic reference value of dehydration (300 mOsm/kg H2O) were classified into the boundary zone group and those with levels of <292 mOsm/kg H2O were classified into the normal range group. The following parameters were measured: basic attributes (age, gender and level of care required), body mass index, diet, daily fluid intake per kilogram of body weight, physiological indicators (blood pressure, pulse rate, body temperature, axillary skin temperature, humidity, total body water, body water rate, internal liquid rate, external solution rate, blood components, intraoral water amount, and salivary components), and the indoor environment (room temperature and humidity). We then performed a statistical analysis to compare the boundary zone group with the normal range group. After adjusting for age and the daily fluid intake per kilogram of body weight (<25 ml/≥25 ml), we performed a logistic regression analysis (the boundary zone group was used as an independent variable) for variables that had significance levels of <0.05 (except for blood components). Results: The univariate analysis revealed significant differences in the following parameters: the serum sodium, chloride, and creatinine levels; the blood sugar level; the urea nitrogen/creatinine ratio; the axillary skin temperature; and room humidity. Only the axillary skin temperature showed a significant association in the final model of the logistic regression analysis (odds ratio, 3.664; 95% confidence interval, 1.101-12.197; p = 0.034). Conclusion: As the axillary skin temperature increased by 1°C, there was a 3.67-fold risk of being classified into the boundary zone group instead of the normal range group. Thus, the axillary skin temperature was associated with impending dehydration.