in individuals with heart failure approaching the end of life, and there is limited knowledge on the best way to manage these individuals [49]. The elevated risk of falling in the elderly with heart failure may be explained by its pharmacotherapy (e.g. diuretics, ACE inhibitors, betablockers) and their association with falls, although these categories of pharmaceuticals did not individually predict falls in our study. Response to pharmacotherapy for heart failure varies in elderly individuals, who are susceptible to adverse events such as orthostatic hypotension, dehydration, electrolyte disturbance, incontinence and drug-drug interactions [47]. One common side effect of diuretics is hyponatraemia, which is associated with impairment of gait and attention. Stable mild chronic hyponatraemia is generally considered asymptomatic, although Renneboog (2006) observed a high number of falls in comparison to controls in hyponatraemic subjects considered clinically asymptomatic. Furthermore, individuals with moderate chronic hyponatraemia fell dramatically more frequently than patients with normal serum sodium levels .