Hyponatremia: Special Considerations in Older Patients

Roy L Soiza, Kirsten Cumming, Jennifer M Clarke, Karen M Wood, Phyo K Myint

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Hyponatremia is especially common in older people. Recent evidence highlights that even mild, chronic hyponatremia can lead to cognitive impairment, falls and fractures, the latter being in part due to bone demineralization and reduced bone quality. Hyponatremia is therefore of special significance in frail older people. Management of hyponatremia in elderly individuals is particularly challenging. The underlying cause is often multi-factorial, a clear history may be difficult to obtain and clinical examination is unreliable. Established treatment modalities are often ineffective and carry considerable risks, especially if the diagnosis of underlying causes is incorrect. Nevertheless, there is some evidence that correction of hyponatremia can improve cognitive performance and postural balance, potentially minimizing the risk of falls and fractures. Oral vasopressin receptor antagonists (vaptans) are a promising innovation, but evidence of their safety and effect on important clinical outcomes in frail elderly individuals is limited.

Original languageEnglish
Pages (from-to)944-958
Number of pages15
JournalJournal of Clinical Medicine
Issue number3
Publication statusPublished - 18 Aug 2014

Bibliographical note

Roy L. Soiza is funded by an NRS Career Research Fellowship.


  • older people
  • hyponatraemia
  • aging
  • arginine vasopressin
  • geriatrics
  • hyponatremia
  • old
  • salt
  • sodium


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