A study of hyponatraemia in the in-patients of a Geriatric Department during a 10-month period showed that 77 patients (11.3%) had plasma sodium concentrations below 130 mmol/l. Thirty-one patients (4.5%) had severe hyponatraemia of less than 125 mmol/l. Seventy-three per cent of hyponatraemias were iatrogenic caused by diuretic or intravenous fluid therapy. Hydrochlorothiazide/amiloride combination has the greatest tendency to produce hyponatraemia compared to all other diuretics (P less than 0.01). Clinical features attributable to hyponatraemia were present in 61%. Nine patients needed hospital admission solely due to hyponatraemia. The mortality rate for hyponatraemia was twice the overall rate for the unit.

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This report concerns the use of d-amphetamine in 88 elderly inpatients who initially failed to respond to rehabilitation procedures. These patients exhibited characteristics of the Poor Motivation Syndrome (PMS), not associated with depression or dementia. The syndrome was seen five times more frequently in women. d-Amphetamine was given for three weeks in increasing dosage (2.5--10.0 mg twice daily). The responses were scored according to mobility, self-care and motivation. Of the 88 patients, 48 improved and another 28 were discharged who would otherwise have remained dependent nursing cases. An unexpected finding was that 17 patients showed an age-related resistance to the effects of the drug (P less than 0.05). The likelihood of a beneficial response also diminished with increasing age (P less than 0.01). Side effects were in the psychiatric sphere; they occurred in 23 patients early in treatment and were not age-related; the drug was withdrawn. Thus treatment with d-amphetamine should be restricted to selected patients who satisfy the diagnostic criteria of PMS, and administration should be carefully supervised. With these safeguards, a substantial proportion of patients previously refractory to rehabilitation will show improvement, become more independent and may be discharged from the hospital in a much more active, less dependent state of mine and body.

The range of plasma concentrations in 177 and erythrocyte magnesium concentrations in 104 elderly patients was found to be similar to that for healthy adults. No significant difference was observed between the sexes or between patients taking diuretics and those not receiving diuretic therapy. The latter finding is contrary to some previously reported studies.

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