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Cited by 127Cardiovascular Syncope and Autonomic DisordersBalance, Gait, and Falls PreventionVestibular and auditory disorders

Diagnosis and characteristics of syncope in older patients referred to geriatric departments

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Ungar, Andrea, Mussi, Chiara, Del Rosso, Attilio, Noro, Gabriele, Abete, Pasquale, Ghirelli, Loredana, Cellai, Tommaso, Landi, Annalisa +5 more·2006·Journal of the American Geriatrics Society
DOI 10.1111/j.1532-5415.2006.00891.x
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Abstract

OBJECTIVES: To test the applicability and safety of a standardized diagnostic algorithm in geriatric departments and to define the prevalence of different causes of syncope in older patients. DESIGN: Multicenter cross-sectional observational study. SETTING: In-hospital geriatric acute care departments and outpatient clinics. PARTICIPANTS: Two hundred forty-two patients (aged>or=65, mean+/-standard deviation=79+/-7, range 65-98) consecutively referred for evaluation of transient loss of consciousness to any of six clinical centers participating in the study. Of these, 11 had a syncope-like condition (5 transient ischemic attack; 6 seizures), and 231 had syncope (aged 65-74, n=71; aged>or=75, n=160). MEASUREMENTS: Protocol designed to define etiology and clinical characteristics of syncope derived from European Society of Cardiology Guidelines on syncope. RESULTS: No major complication occurred with use of the protocol. Neurally mediated was the more prevalent form of syncope in this population (66.6%). Cardiac causes accounted for 14.7% of all cases. The neuroreflex form of syncope (vasovagal, situational, and carotid sinus syndrome) was more common in younger than in older patients (62.3% vs 36.2%; P=.001), whereas orthostatic syncope was more frequent in the older than in the younger group (30.5% vs 4.2%; P<.001). In only 10.4% of cases, syncope remained of unexplained origin. After initial evaluation, a definite diagnosis was possible in 40.1% of the cases, and a suspected diagnosis was obtained in 57.9%. Syncope of suspected cardiac origin after initial evaluation was confirmed in 43.7% of cases, and neuromediated causes were confirmed in 83.5% of the cases. CONCLUSION: The protocol is applicable even beyond the age of 90 in geriatric departments. The standardized protocol is associated with a reduction in the frequency of unexplained syncope to about 10%.

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Authors
Ungar, A., Mussi, C., Del Rosso, A., Noro, G., Abete, P., Ghirelli, L., Cellai, T., Landi, A., Salvioli, G., Rengo, F., Marchionni, N., Masotti, G., & for the Italian Group for the Study of Syncope in the Elderly
Affiliations
University of Modena and Reggio Emilia (IT)
Corresponding author
Ungar, Andrea
ORCID
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2006-09-15
Volume
54
Issue
10
Pages
1531-1536
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/j.1532-5415.2006.00891.x
OpenAlex
W2152101062
Cited by
127
References
24
Citations by year
2026: 2 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 10 · 2021: 4 · 2019: 2 · 2018: 11 · 2017: 10 · 2016: 6 · 2015: 4 · 2014: 15 · 2013: 14 · 2012: 7
FWCI
7.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
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
  • Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
Keywords
syncope, older adults, geriatric departments, diagnostic algorithm, syncope etiology, neurally mediated syncope, vasovagal syncope, carotid sinus syndrome, orthostatic syncope, cardiac syncope, transient ischemic attack, seizures, unexplained syncope
MeSH terms
Age Factors, Aged, Aged, 80 and over, Algorithms, Cross-Sectional Studies, Decision Trees, Female, Health Services for the Aged, Hospital Departments, Humans, Male, Middle Aged, Referral and Consultation, Syncope, Geriatric Assessment

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