Syncope in an elderly, institutionalised population: prevalence, incidence, and associated risk
Lipsitz, L.A.; Wei, J.Y.; Rowe, J.W.
Quarterly Journal of Medicine 55(216): 45-54
1985
ISSN/ISBN: 0033-5622 PMID: 4011842 Document Number: 245128
Although syncope is common in the elderly, little is known of its epidemiology and prognosis. A retrospective analysis of syncope in 711 very old (mean age 87 yr) institutionalized patients revealed a 10 yr prevalence of 23% and 1 yr incidence of 7%. A 2-yr prospective follow-up of this population revealed a yearly incidence of 6% and recurrence rate of 30%. Of 67 patients who developed syncope during follow-up, a cause was established in 46; 14 (21%) had cardiac and 32 (48%) had non-cardiac etiologies. Twenty-one cases (31%) remained unexplained. Patients who developed syncope were initially more functionally disabled (P = 0.003) and subsequently changed function more frequently (P = 0.03) than those without the development of syncope, but 2 yr rates of hospitalization and death were not different between the 2 groups. Life-table survival analysis showed no difference in the mortality of subgroups with cardiac, non-cardiac, and unknown etiologies of syncope. Syncope is common in multiple impaired elders and is likely a manifestation of co-morbid disease rather than an independent contributor to mortality.