Cognition and Fall Assessment After Recovery from Syndrome of Inappropriate Anti-Diuresis

Background/Objectives: The syndrome of inappropriate antidiuresis (SIAD) is a common cause of hyponatremia, often leading to cognitive dysfunction, gait instability, and a greater risk of falls. While the treatment of symptomatic hyponatremia addresses the immediate electrolyte imbalance, the longer-term effects are not well understood. This study aimed to evaluate cognitive function and fall risk in patients 1–2 months after recovery from SIAD-related hyponatremia by comparing them with matched controls. Methods: This cross-sectional study included 40 patients who had recently recovered from SIAD-related hyponatremia and 40 age- and sex-matched controls. Cognitive function was assessed via the Mini-Cog and Trail Making Tests A and B, postural stability was assessed via the Timed Up and Go test, and functional independence was assessed via the Katz Index of Independence. Serum sodium levels were measured at discharge and during follow-up. Statistical analysis was conducted to compare outcomes between the two groups. Results: Patients who recovered from SIAD-related hyponatremia presented significant impairments in cognition and functional performance at the time of discharge, including lower Mini-Cog scores, prolonged Timed Up and Go times, and reduced Katz index scores. At the 1–2-month follow-up, these measures improved significantly (p<0.001), but patients still lagged behind controls, particularly in executive function, as seen in Trail Making Test B scores (239.6 ± 106.3 seconds vs. 173.1 ± 80.7 seconds, p=0.002). Conclusions: Persistent deficits, particularly in executive function and mobility, highlight the importance of continued rehabilitation and monitoring to reduce fall risk and improve long-term outcomes. This study emphasizes the need for a multidisciplinary approach to care following recovery from SIAD.