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Table 3 Hyponatremia and cognitive impairment: characteristics of the studies included in the review

From: Hyponatremia and aging-related diseases: key player or innocent bystander? A systematic review

Study

Study design

Sodium level

Definition of hyponatremia used

Timing of sodium measurement

Participants

(number)

Age of participants

(years)

Gender

Etiology of hyponatremia

Cognitive scores

Diuretics

Main outcome

Chung et al. (2017) [48]

Retrospective cohort

Not reported

According to ICD-9-CM, no further definition

Single at baseline

24,445

No. of subjects < 65 years:

1797 (36.7%)

No. of subjects > 65 years: 3103 (63.3%)

44.8% F

Hyponatremia related to heart failure, liver cirrhosis, diabetes, malignancy, diuretic use

Dementia diagnosed according to ICD-9-CM

Furosemide, thiazides. Dosage not reported

Hyponatremia as a predictor of dementia

C. Fujisawa et al. (2021) [49]

Prospective cohort

Not reported

Serum sodium < 135 mEq/l

Single at baseline

2982

82.0 (76.0–84.0) in hyponatremic vs 79.0 (75–83) in normonatremic

Median years (IQR)

48% F

Hyponatremia related to cardiac disease, liver disease, diabetes, diuretic use

MMSE, FAB, Digit span forward, Digit span backward, category fluency, logical memory

Type and dosage of diuretics not specified

Association between hyponatremia and cognitive impairment, muscle mass, physical performance

Gosch et al. (2012) [13]

Case control

128 ± 3.2 mEq/l (mean ± SD) in hyponatremic group

Serum sodium < 135 mEq/l

Single at admission

2880

78.6 (6.98)

Mean years (SD)

75.6% F

Hypo- (4.7%), and normo-osmolar (1.6%) hyponatremia, adverse drug reaction (15.5%), hyponatremia related to heart failure (3.1%), severe liver disease (0.8%), cancer (1.6%), adrenal insufficiency (1.6%), SIADH (0.8%)

MMSE, clock completion

Type and dosage of diuretic not specified

Effect of hyponatremia on CGA

Pereira et al. (2006) [50]

Prospective cohort

Not reported

Serum sodium < 135 mEq/l

Single at baseline

306

74 (8.7)

Mean years (SD)

50.33% F

Not evaluated

BLAD

Not evaluated

Frequency of laboratory abnormality in MCI and dementia

Suárez et al. (2020) [51]

Prospective cohort

122 mEq/l (median) in hyponatremia group

Serum sodium < 130 mEq/l

Single at admission

180

68 (61–78, cases), 72 (65–78) controls

Median years (IQR)

52.31% F

Hyponatremia related to congestive heart disease, liver disease, chronic renal disease, diabetes, malignancy

MMSE, DemTect test, trail-making tests A and B

Thiazides, loop diuretics. Dosage not reported

Differences in cognitive performances between groups, and before and after treatment

  1. MMSE mini-mental state examination, FAB frontal assessment battery, CGA comprehensive geriatric assessment, TMSE Thai Mental State Examination, BLAD Battery of Lisbon for the Assessment of Dementia, MCI mild cognitive impairment, DemTect dementia detection