Dr. Maria Panourgia: why we need to stay well hydrated as we age

Hydration is key to health and staying well hydrated throughout our lives is important for both our physical and brain health. The ‘Drink’ action area of Take Five is all about staying hydrated and the quality of what we drink such as reducing alcohol intake. Our academic advisor, Dr. Maria Panourgia, Consultant geriatrician and Honorary Lecturer at Buckingham University Medical School, explains the importance of hydration for older adults.
 

What led you into geriatrics?

My interest in Geriatric Medicine was sparked by a professor I met during my studies—someone who deeply inspired me through his compassionate approach to care. He truly connected with the older adults he worked with, understanding not only their clinical needs but also their personal stories and challenges. That experience opened my eyes to the richness and complexity of Geriatrics. What draws me most to this field is its multidimensional nature. It combines medicine, social care, and deep human connection. To work in Geriatrics, you need more than clinical knowledge—you need empathy, patience, and the ability to support families who are often going through difficult times. Each patient is unique, with their own values, goals, and life experience, and that makes the work both challenging and deeply meaningful. Medically, I find Geriatrics intellectually rewarding. It requires a holistic mindset—connecting the dots between multiple body systems and seeing how they interact in the context of aging. It demands the ability to individualise treatment. I also have a strong interest in the science that underpins Geriatric medicine. My PhD explored the mechanisms of longevity, particularly how the immune system evolves with age. That research gave me an understanding of the, evidence-base driving geriatric care. As geriatricians, we don't just care—we know our field, and we know it well.

What do we mean when we say, ‘it’s important to stay well hydrated’?

First of all, the best doctor is the one who prevents rather than cures. Prevention lies at the heart of high-quality geriatric care, and one important area is hydration. As we age, bodily changes—including alterations in brain function—can reduce the sense of thirst, making older adults more prone to dehydration. Also, many patients are prescribed medications which might have diuretic effects, increasing fluid loss. Incontinence, another common issue, can mean that some people may avoid drinking much fluid—particularly when access to toilets is limited. Similarly, many older adults limit their fluid intake in the evening to avoid disrupting their sleep with frequent trips to the toilet. These factors combined create a risk of dehydration, which can have wide-ranging effects on health. It can impact kidney function, affect metabolism, change cognitive performance, and increase the risk of falls. For example, dehydration can lower blood pressure, and when combined with certain (antihypertensive) medications this can mean that standing up too quickly , can lead to dizziness or loss of balance, making falls more likely. That’s why promoting awareness around hydration and encouraging people to stay well hydrated is important throughout life but particularly in older years.

So, what's your advice to any older adults that might be reading this?

When it comes to staying well hydrated, the key is making it practical and enjoyable. Start by choosing drinks that you like—hydration doesn’t have to mean plain water. While alcohol should be limited, many people find that adding a slice of lemon in their water, opting for a diluted squash, or choosing herbal teas makes it easier to drink regularly throughout the day. The right amount of fluid varies from person to person. Some individuals, particularly those with heart or kidney conditions, may be given specific guidance on fluid intake. However, for most people, aiming for 1.5 to 2 litres of fluid per day is a good general rule. A useful way to check if you’re drinking enough is to monitor your urine: it should be pale in colour and not have a strong smell. Passing urine regularly is another good sign. If you’re unsure about what’s right for you, speak with your doctor or healthcare professional. Staying hydrated is one of the simplest yet very effective ways to support your overall health—especially as you age.

What are in general, as a geriatrician, your top tips for aging well?

We need to begin investing in our health and wellbeing well before old age, ideally from middle age or even earlier. The truth is: the earlier, the better, but it’s never too late to make a difference. The way we treat our bodies today has a direct impact on how well we age. Thanks to advances in modern medicine, many of us can expect to live longer and in better health, than previous generations. But to truly enjoy those later years, we must take an active role in caring for ourselves now. That means prioritising five key pillars: good nutrition, adequate hydration, regular movement, socialising and to keep our brain active. Engaging in activities you enjoy, especially with others, can be incredibly beneficial. Whether it’s walking groups, dancing, swimming, or simply a coffee morning with conversation, these not only keep your body moving but also stimulate your brain and support emotional wellbeing. I would never simply say "stop being stressed"—modern life is stressful, and that advice alone isn’t realistic. But stress can be managed, especially if we balance it with activities that bring us joy and help us feel connected. Healthy ageing is not just about adding years to life, but life to years.

Great, thank you. And finally, why do you think Take Five is a good idea?

We live in a society that loves checklists, often placing external responsibilities, like work, family, friends, above our own wellbeing. Many people tend to prioritise everything and everyone else before themselves. But I once had a very wise colleague who asked me, “Who is the most important person in your life?” I replied, “My family.” And he said, “No, it’s you.” His point was simple but powerful: if you’re not in good health, physically, mentally, or emotionally, then the people you love will be affected. You cannot give your best to others if you’re not taking care of yourself. Take Five, is a framework for healthy ageing based on five key pillars: Nutrition, Hydration, Movement, Social Connection, and Thinking. These are the foundations of lifelong wellbeing. Each one supports not only your own health, but your ability to live well and care for those around you. It’s the same principle as the airline safety message: put your own oxygen mask on before helping others. Self-care isn’t selfish, it’s essential. It’s time we give ourselves permission to prioritise our health. We need to care for ourselves in order to care for others.

THANK YOU FOR READING