Earlier this week, the National Institute of Aging released "Tips for Older Adults to Combat Heat-Related Illnesses " noting that the "risk of heat-related problems increases with age." That's a timely warning as summer's sweltering days lie immediately ahead. While timely, the advice is incomplete and incomplete for the reason of ensuring the advice is politically-correct -- if not medically correct.

Older people need to heed the warning. They are at extra risk of hyperthermia as the NIA warns. And, in fairness, buried in the release is the notation that low-salt diets "may increase their risks."

Rather than include any action steps to heat-threatened seniors to safeguard their salt (and total electrolyte) intakes, however, NIA contents itself with advice to consume water and fruit/vegetable juice. Replacing fluids without replenishing electrolytes (like salt) can be fatal to those suffering hyperthermia, leading to hyponatremia. Every summer, thousands die not appreciating that hydration is critical and proper hydration requires attention to electrolyte balance.

The American Medical Assocation's JAMA journal examined the situation in women and documented the importance of salt therapy:

Chronic hyponatremia is a common clinical problem in the elderly, particularly among women. Mortality is substantial. It is now well accepted that acute symptomatic hyponatremia (hyponatremic encephalopathy) can result in death or permanent brain damage. While failure to institute active therapy (intravenous [IV] sodium chloride) in such patients may lead to increased morbidity, IV hypertonic sodium chloride therapy is both safe and effective in preventing hyponatremic brain damage.

Seniors would be well advised to take NIA's warnings seriously, but take the agency's remedial advice with a grain of salt.

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