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Syncope in the elderly.

W Kapoor, D Snustad, J Peterson

    The American Journal of Medicine
    |March 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

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    Elderly patients experiencing syncope (fainting) have higher risks of cardiovascular causes and mortality compared to younger individuals. Non-cardiovascular causes and unknown origins also present significant mortality risks in older adults.

    Area of Science:

    • Gerontology
    • Cardiology
    • Internal Medicine

    Background:

    • Syncope is a common clinical problem, particularly in the elderly.
    • Understanding age-related differences in syncope etiology and outcomes is crucial for effective management.

    Purpose of the Study:

    • To compare the causes, diagnostic yield of prolonged electrocardiographic monitoring, trauma incidence, and mortality of syncope in elderly versus younger patients.
    • To identify prognostic factors for mortality and sudden death in elderly patients with syncope.

    Main Methods:

    • Retrospective evaluation of 210 elderly (mean age 71) and 190 younger (mean age 39) patients presenting with syncope.
    • Analysis of etiological categories (cardiovascular, noncardiovascular, unknown), diagnostic methods, trauma, and two-year mortality.

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  • Multivariate analyses to determine risk factors for mortality and sudden death.

    • Main Results:

    • Elderly patients had a higher incidence of cardiovascular causes (33.8% vs 16.8%) and significantly higher two-year mortality (26.9% vs 8.3%) compared to younger patients.
    • Prolonged electrocardiographic monitoring yielded diagnoses more frequently in the elderly (17% vs 8%).
    • In elderly patients, non-cardiovascular syncope and syncope of unknown cause were associated with higher mortality and sudden death rates than in younger patients.

    Conclusions:

    • Cardiovascular causes of syncope are a strong risk factor for mortality in the elderly.
    • Older age, male sex, and history of congestive heart failure are important prognostic factors in elderly patients with non-cardiovascular syncope or syncope of unknown cause.
    • Syncope evaluation in the elderly requires careful consideration of cardiovascular causes and associated comorbidities due to higher mortality risks.