A Systematic Approach to Nontraumatic Falls: Integrating Tilt Table Testing and Amnesia Screening in Clinical...

Nontraumatic falls in older adults pose a significant public health issue. Syncope, a temporary loss of consciousness due to global cerebral hypoperfusion, is a frequent and often underrecognized cause of falls. Early identification of syncope is vital for effective management and fall prevention.

This study aimed to assess the prevalence of syncope as a cause of nontraumatic falls in individuals over fifty years of age, characterize their clinical profiles, and evaluate the effectiveness of the Tilt Table Test (TTT) in diagnosis.

This observational study was conducted in patients over 50 years of age presenting with nontraumatic falls. Those with recent transient ischaemic attack/stroke, significant carotid stenosis, severe cardiac conditions, or inability to comply with instructions were excluded. Data collection involved a proforma covering demographics, fall characteristics, and diagnostic evaluations, including TTT and carotid sinus massage (CSM), following ESC 2018 guidelines. Statistical analysis was performed via SPSS (version 29).

Sixty-five participants were included, with a mean age of 68.34 ± 10.95 years; 63.1% were male. Intrinsic factors were responsible for falls in 72.3% of cases. TTT results indicated 32.7% positive results for syncope. A significant association was noted between syncope and amnesia (p=0.015).

Syncope is an overlooked cause of nontraumatic falls in elderly individuals. The TTT proved valuable in diagnosing syncope-related falls. The strong association between amnesia and syncope in our study emphasizes the need for detailed evaluation to improve outcomes and reduce the incidence of recurrent falls.