The relationship between syncope, depression and anti-depressant use in older adults
Open accessAbstract
BACKGROUND: syncope is a common problem which increases in older age groups. In syncope clinics, patients who are depressed have higher rates of unexplained syncope and higher rates of recurrent syncope. OBJECTIVES: : we aim to examine the rates of depression in older patients reporting syncope and the effect of anti-depressants (ADs) on the rates of syncope. DESIGN: : epidemiological, point-prevalence study. SETTING AND PARTICIPANTS: : data came from the Irish Longitudinal Study on Ageing, which includes 8,175 adults aged 50 and older, living in the community in Ireland. MEASUREMENTS: : the Centre for Epidemiological Studies Depression scale was used to assess levels of depression. Multinomial regression was used to analyse the data with a P-value of <0.05 determining significance. RESULTS: : 7,993 participants aged 50 and older were included, and of these 349 reported at least one syncopal episode in the last year. Prevalence of syncope was 4.4%. After controlling for participant characteristics and general health, those with severe depression had a greater risk of single and multiple syncopal events (relative risk ratios [RRR]: 2.78 and 2.84, respectively, P < 0.050) and participants treated with tricyclic anti-depressants (TCAs) were also at greater risk for single and multiple syncopal episode in the last year (RRR: 2.31, P = 0.062; RRR: 2.95, P < 0.05). CONCLUSIONS: : this study demonstrates an increased risk of syncope in patients with depression, with higher rates of syncope reported with increasing severity of depression. Treatment with TCAs increases both the risk and frequency of syncope in the community. Depression is a potentially modifiable risk factor for syncope but treatment options need to be tailored in the older patient population.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Older patients frequently have abnormal findings on more than one investigation and may have more than one possible cause of syncope.
“Older patients frequently have abnormal findings on more than one investigation and may have more than one possible cause of syncope. 372,374,376”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [376]
The Introduction (page not specified) says that multiple causes of syncope are often present in older patients, supporting the second part of the claim. Our copy does not report that older patients frequently have abnormal findings on more than one investigation. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Assessing depressive symptoms in five psychiatric populations: a validation study.
Weissman, M., Sholomskas, D., Pottenger, M., Prusoff, B., & Locke, B. Z. (1977) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112455 · Cited by 2,232 · see citing works
Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040 · see citing works
Self-citationIncidence and Prognosis of Syncope
Soteriades, E. S., Evans, J. C., Larson, M. G., Chen, M. H., Chen, L., Benjamin, E. J., & Levy, D. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa012407 · Cited by 1,364 · see citing works
Antidepressant use and risk of adverse outcomes in older people: population based cohort study
Coupland, C., Dhiman, P., Morriss, R., Arthur, A., Barton, G., & Hippisley-Cox, J. (2011) · BMJ · doi:10.1136/bmj.d4551 · Cited by 833 · see citing works
Liu, B., Anderson, G., Mittmann, N., To, T. M., Axcell, T., & Shear, N. H. (1998) · The Lancet · doi:10.1016/s0140-6736(97)09528-7 · Cited by 387 · see citing works
GANZEBOOM, K. S., MAIRUHU, G., REITSMA, J. B., LINZER, M., WIELING, W., & VAN DIJK, N. (2006) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2006.00595.x · Cited by 375 · see citing works
Gum, A. M., King-Kallimanis, B., & Kohn, R. (2009) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181ad4f5a · Cited by 357 · see citing works
Self-citationCohort Profile: The Irish Longitudinal Study on Ageing
Kearney, P. M., Cronin, H., O’Regan, C., Kamiya, Y., Savva, G. M., Whelan, B., & Kenny, R. A. (2011) · International Journal of Epidemiology · doi:10.1093/ije/dyr116 · Cited by 351 · see citing works
Self-citationDi Girolamo, E., Di Iorio, C., Sabatini, P., Leonzio, L., Barbone, C., & Barsotti, A. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00694-9 · Cited by 322 · see citing works
Moore, M., Yuen, H. M., Dunn, N., Mullee, M. A., Maskell, J., & Kendrick, T. (2009) · BMJ · doi:10.1136/bmj.b3999 · Cited by 287 · see citing works
Epidemiology of reflex syncope
Colman, N., Nahm, K., Ganzeboom, K. S., Shen, W.-K., Reitsma, J. B., Linzer, M., Wieling, W., & Kaufmann, H. (2004) · Clinical Autonomic Research · doi:10.1007/s10286-004-1003-3 · Cited by 278 · see citing works
Kapoor, W. N., Snustad, D. G., Peterson, J. R., Wieand, H. S., Cha, R., & Karpf, M. (1986) · The American Journal of Medicine · doi:10.1016/0002-9343(86)90716-3 · Cited by 202 · see citing works
Falls, Depression and Antidepressants in Later Life: A Large Primary Care Appraisal
Kerse, N. M., Flicker, L. A., Pfaff, J. J., Draper, B., Lautenschlager, N. T., Sim, M., Snowdon, J. A., & Almeida, O. P. (2008) · PLoS ONE · doi:10.1371/journal.pone.0002423 · Cited by 152 · see citing works
Usefulness of Fluoxetine Hydrochloride for Prevention of Resistant Upright Tilt Induced Syncope
Grubb, B. P., Wolfe, D. A., Samoil, D., Temesy‐Armos, P. N., Hahn, H., & Elliott, L. (1993) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1993.tb01608.x · Cited by 148 · see citing works
Pacher, P., Ungvari, Z. I., Nánási, P. P., Fürst, S., & Kecskeméti, V. (1999) · Current Medicinal Chemistry · doi:10.2174/0929867306666220330184544 · Cited by 121 · see citing works
Influence of age and gender on the occurrence and presentation of reflex syncope
Romme, J. J. C. M., van Dijk, N., Boer, K. R., Dekker, L. R. C., Stam, J., Reitsma, J. B., & Wieling, W. (2008) · Clinical Autonomic Research · doi:10.1007/s10286-008-0465-0 · Cited by 115 · see citing works
Prevalence, duration and indications for prescribing of antidepressants in primary care
Petty, D. R., House, A., Knapp, P., Raynor, T., & Zermansky, A. (2006) · Age and Ageing · doi:10.1093/ageing/afl023 · Cited by 110 · see citing works
Proarrhythmic Risk with Antipsychotic and Antidepressant Drugs
Vieweg, W. V. R., Wood, M. A., Fernandez, A., Beatty-Brooks, M., Hasnain, M., & Pandurangi, A. K. (2009) · Drugs & Aging · doi:10.2165/11318880-000000000-00000 · Cited by 106 · see citing works
Vasovagal Syncope in the Older Patient
Tan, M. P., & Parry, S. W. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.11.025 · Cited by 92 · see citing works
Medically unexplained syncope: Relationship to psychiatric illness
Linzer, M., Varia, I., Pontinen, M., Divine, G., Grubb, B. P., & Estes, N. A. M. (1992) · The American Journal of Medicine · doi:10.1016/0002-9343(92)90132-u · Cited by 87 · see citing works
SUMNER, G. L., ROSE, M. S., KOSHMAN, M. L., RITCHIE, D., SHELDON, R. S., & for the Prevention of Syncope Trial Investigators (2010) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2010.01848.x · Cited by 80 · see citing works
Epidemiology of syncope in hospitalized patients
Getchell, W. S., Larsen, G. C., Morris, C. D., & McAnulty, J. H. (1999) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1999.03199.x · Cited by 79 · see citing works
Kouakam, C., Lacroix, D., Klug, D., Baux, P., Marquié, C., & Kacet, S. (2002) · The American Journal of Cardiology · doi:10.1016/s0002-9149(01)02292-5 · Cited by 76 · see citing works
D’Antono, B., Dupuis, G., St-Jean, K., Lévesque, K., Nadeau, R. A., Guerra, P. G., Thibault, B., & Kuś, T. (2009) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.03.012 · Cited by 57 · see citing works
Two-year morbidity and mortality in elderly patients with syncope
Ungar, A., Galizia, G., Morrione, A., Mussi, C., Noro, G., Ghirelli, L., Masotti, G., Rengo, F., Marchionni, N., & Abete, P. (2011) · Age and Ageing · doi:10.1093/ageing/afr109 · Cited by 56 · see citing works
Pacher, P., Ungvari, Z. I., Kecskeméti, V., et al. (1998) · PubMed · Cited by 52 · see citing works
Pacher, P., Ungvari, Z. I., Kecskeméti, V., et al. (1998) · Current Medicinal Chemistry · doi:10.2174/0929867305666220319103330 · Cited by 36 · see citing works
Harris, T. J., Carey, I. M., Shah, S. M., DeWilde, S., & Cook, D. G. (2010) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2010.09.005 · Cited by 31 · see citing works
Cardiogenic syncope and serotonin reuptake inhibitors.
Kremastinos, D. T. (2008) · PubMed · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 15
- Schofield I, Stott DJ, Tolson D, McFadyen A, Monaghan J, Nelson D. Screening for cognitive impairment in older people attending accident and emergency using the 4-item Abbreviated Mental Test. Eur J Emerg Med 2010; 17: 340-2.
- Katzman R, Brown T, Fuld P, Peck A, Schechter R, Schimmel H. Validation of a short orientation-memory-concentration test of cognitive impairment. Am J Psychiatry 1983; 140: 734-9.
- Malek-Ahmadi M, Davis K, Belden C et al. Validation and diagnostic accuracy of the Alzheimer's questionnaire. Age Ageing 2012; 41: 396-9.
- Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry 1982; 140: 566-72.
- Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373-83.
- Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med 1990; 113: 941-8.
- Ely EW, Inouye SK, Bernard GR et al. Delirium in mechanical- ly ventilated patients: validity and reliability of the confusion as- sessment method for the intensive care unit (CAM-ICU). JAMA 2001; 286: 2703-10.
- Kean J, Ryan K. Delirium detection in clinical practice and research: critique of current tools and suggestions for future development. J Psychosom Res 2008; 65: 255-9.
- Wong CL, Holroyd-Leduc J, Simel DL, Straus SE. Does this patient have delirium? Value of bedside instruments. JAMA 2010; 304: 779-86.
- Young RS, Arseven A. Diagnosing delirium. JAMA 2010; 304: 2125-6.
- Hall RJ, Meagher DJ, MacLullich AM. Delirium detection and monitoring outside the ICU. Best Pract Res Clin Anaesthesiol 2012; 26: 367-83.
- Morandi A, McCurley J, Vasilevskis EE et al. Tools to detect delirium superimposed on dementia: a systematic review. J Am Geriatr Soc 2012; 60: 2005-13.
- Ryan DJ, O'Regan NA, Caoimh RO et al. Delirium in an adult acute hospital population: predictors, prevalence and detec- tion. BMJ Open 2013; 3: doi:pii: e001772. 10.1136/bmjopen- 2012-001772. · DOI
- Brown LJ, Fordyce C, Zaghdani H, Starr JM, MacLullich AM. Detecting deficits of sustained visual attention in delirium. J Neurol Neurosurg Psychiatry 2011; 82: 1334-40.
- Moya A, Sutton R, Ammirati F et al. Guidelines for the diagno- sis and management of syncope (version 2009). Eur Heart J 2009; 30: 2631-71.
Cited by
Sorted by citations
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951 · see citing works
Self-citationChildhood trauma and lifetime syncope burden among older adults
O'Hare, C., McCrory, C., O'Leary, N., O'Brien, H., & Kenny, R. A. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.03.019 · Cited by 18 · see citing works
Self-citation
- Authors
- Bhangu, J. S., King-Kallimanis, B., Cunningham, C., & Kenny, R. A.
- Affiliations
- Trinity College Dublin (IE)
- St. James's Hospital (IE)
- Corresponding author
- Bhangu, Jaspreet S.
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-02-03
- Volume
- 43
- Issue
- 4
- Pages
- 502-509
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W2103161046
- Cited by
- 28
- References
- 30
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 7 · 2017: 6 · 2016: 2 · 2014: 1
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by-nc-sa
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-sa)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- syncope, depression, antidepressants, tricyclic antidepressants, older adults, recurrent syncope, depression severity, community-dwelling older adults
- MeSH terms
- Aged, Aged, 80 and over, Antidepressive Agents, Tricyclic, Depression, Female, Humans, Ireland, Longitudinal Studies, Male, Middle Aged, Regression Analysis, Risk Factors, Severity of Illness Index, Syncope, Geriatric Assessment, Prevalence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
