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The overlap between syncope and falls in the elderly

F E Shaw1, R A Kenny

  • 1Department of Medicine (Geriatric Medicine), Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Postgraduate Medical Journal
|March 14, 1998
PubMed
Summary
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Falls in the elderly may be caused by syncope, a condition often overlooked. Recognizing this overlap improves diagnosis and treatment for elderly fall patients.

Area of Science:

  • Geriatrics
  • Cardiology
  • Neurology

Background:

  • Syncope and falls are typically viewed as distinct diagnoses.
  • An overlap between syncope and falls, particularly in the elderly, is increasingly recognized.
  • Diagnosing fall aetiologies in the elderly is challenging due to recall issues and lack of witnesses.

Purpose of the Study:

  • To investigate the potential overlap between syncope and falls in the elderly.
  • To highlight the diagnostic and healthcare implications of this overlap.

Main Methods:

  • Analysis of patient presentations where falls were the primary symptom.
  • Review of diagnoses in patients with carotid sinus syndrome.
  • Examination of haemodynamic changes in patients experiencing syncope or falls.

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Main Results:

  • Nearly 40% of carotid sinus syndrome diagnoses presented solely with falls or falls with dizziness.
  • Amnesia for loss of consciousness occurred in over 20% of carotid sinus syndrome patients, and 50% of those presenting with only falls/dizziness.
  • Similar haemodynamic changes were observed in patients reporting syncope versus falls.

Conclusions:

  • Syncope should be considered in the differential diagnosis of unexplained falls in the elderly.
  • Failure to recognize syncope as a cause of falls can lead to missed cardiovascular diagnoses and delayed treatment.
  • Integrating syncope evaluation into fall assessment can improve diagnostic accuracy and patient care.