What Causes Swelling in the Lower Legs of Elderly People?

Edema of the lower legs in elderly individuals is commonly associated with deficiency of spleen and kidney yang, leading to internal retention of dampness and water. So, what causes lower-leg edema in the elderly?

Causes of Lower-Leg Edema in the Elderly

Deep vein thrombosis or venous valve insufficiency in the bilateral lower limbs can impede venous return, elevate intravenous pressure, and cause plasma to leak into the interstitial spaces—resulting in edema. Global heart failure or right-sided heart failure—due to diminished cardiac pumping function or increased right-heart pressure from other causes—can impair inferior vena cava return, causing blood to pool in the lower extremities. Edema typically begins in the feet and gradually progresses upward to involve the calves; it is pitting in nature. Nephrotic syndrome or glomerulonephritis may also cause bilateral leg swelling, but this is usually accompanied by periorbital, facial, and generalized edema.

Liver cirrhosis or malnutrition may lead to hypoalbuminemia, which can likewise cause edema—typically generalized. In addition to lower-leg edema, patients may present with ascites and pleural effusion. Spleen-stomach deficiency impairs transformation and transportation functions, resulting in internal accumulation of dampness and water; this pattern is commonly accompanied by fatigue, poor appetite, lower-limb edema (with pitting that recovers slowly upon pressure), diarrhea, pale tongue with white coating, and a fine, soft pulse. Treatment focuses on strengthening the spleen and promoting diuresis. Kidney-yang deficiency impairs the warming and transformation of fluids, allowing dampness and water to accumulate in the muscles and skin; typical symptoms include aversion to cold, cold limbs, soreness and weakness of the lower back and knees, lower-limb edema, and oliguria. Treatment aims to warm the kidney yang and promote diuresis.

Additionally, other pathogenic factors—such as blood stasis—may also contribute to edema. We hope this explanation proves helpful to you!