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Hyponatremia in Elderly: Causes, Symptoms, Treatment

Hyponatremia is a medical condition characterized by low concentration of sodium in the blood. Sodium acts like a vital electrolyte that helps to regulate the water balance in the body. A person is said to have hyponatremia if their blood sodium concentration is less than 135mEq/L. Age, race and diet are certain factors which affect one’s chance of getting hyponatremia. Let us look at the common causes of hyponatremia in elderly, it symptoms and treatment.

Hyponatremia in Elderly

Hyponatremia in Elderly

Hyponatremia widely affects the geriatric age group, especially hospitalized elderly patients. This health issue can range from being mild, to moderate, to severe. The common causes of hyponatremia in elderly range from mild physiological causes to severe illnesses. The symptoms of hyponatremia in elderly too vary depending on the severity of the illness. Milder type of hyponatremia can cause extreme malaise and lethargy while in its severe form, hyponatremia can trigger confusion, altered sensorium and even death.

What are the Common Causes of Hyponatremia in Elderly?

As one grows older, the renal sodium-conserving ability of their body starts getting impaired leading to sodium depletion in their body. This is a normal part of aging. These physiological changes in the water regulatory system of the body, makes hyponatremia more common in the elderly.

Also, use of certain medicines like anti-inflammatory drugs or diuretics, are believed to be some of the common causes of hyponatremia in elderly. Also, the presence of some type of illness further increases their risk of developing hyponatremia. Some of the common causes of hyponatremia in elderly include co-existing diseases like dehydration, chronic kidney failure, congestive cardiac failure, lung disease, chronic liver disease and urinary tract infection. The presence of these conditions usually increases the risk of hyponatremia in elderly.

What are the Symptoms of Hyponatremia in Elderly?

The symptoms of hyponatremia in elderly depend on its severity and the underlying cause. The symptoms are more prominent in acute hyponatremia. In such cases, the symptoms of hyponatremia in elderly usually include nausea, vomiting, headache, muscle cramps, lassitude, irrelevant talking, severe fatigue, seizures and coma. More serious symptoms of hyponatremia in elderly include confusion and disorientation which can further cause gait problems, frequent fall, and fractures. The risk of fatality increases for patients with blood sodium level of 110mEq/L, especially if these individuals are also suffering from other underlying related comorbidity.

How to Diagnose Hyponatremia in Elderly?

Since symptoms of hyponatremia in elderly are non-specific, patients would need to undergo a blood test measuring the sodium level, to confirm the diagnosis of hyponatremia. The doctor may even enquire about the patient’s medical history for the purpose of diagnosis. Depending on the common causes of hyponatremia in elderly and the existing symptoms, additional blood tests, imaging tests and urine tests be ordered.

What is the Treatment of hyponatremia in Elderly?

Hyponatremia in elderly is considered to be a serious condition because of the associated risk of morbidity and mortality. Treatment of hyponatremia in elderly revolves around finding the underlying cause, diagnosing the condition and treating it promptly. Presence of neurological symptoms and the severity of hyponatremia also play an important role in determining the right course of treatment of hyponatremia in elderly.

For treatment of moderate and chronic hyponatremia in elderly, caused by excessive intake water and fluids, improper diet or consumption of diuretics, appropriate changes are advised. The physician may ask to reduce their liquid intake, adjust salt intake and stay under strict monitoring. In case of patients suffering from congestive heart failure, chronic renal failure and chronic liver disease, the doctor may restrict their fluid intake and even adjust the dose of diuretics.

Treatment of acute and severe form of hyponatremia in elderly may need immediate hospitalization for the administration of intravenous sodium solution in their body to boost their blood sodium level. Other medications may also be given to relieve associated symptoms like nausea, vomiting and headache, in addition to the treatment of hyponatremia in elderly.

Final Take

Hyponatremia in elderly is very common and can result in cognitive changes and even seizures in the patient, if not recognized and treated in time. Treatment of hyponatremia in elderly depends on its cause. Changing the medicine which affects the sodium level, managing the underlying illness, regulating the intake of water and salt in diet are some simple ways through which hyponatremia can be managed successfully.


  1. Cleveland Clinic: Hyponatremia
  2. Healthline: Hyponatremia: Low Sodium
  3. MedlinePlus: Hyponatremia

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:September 19, 2023

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