Key Points
- To review the complex, multifactorial mechanisms of syncope in older adults and evaluate the need for a comprehensive geriatric management strategy.
- Reviewed clinical characteristics and diagnostic challenges across neural, orthostatic, postprandial, and cardiac etiologies of syncope in older cohorts.
- Analyzed the interactions among age-associated physiological changes, multimorbidity, polypharmacy, and frailty.
- Older individuals frequently experience syncope from concurrent etiologies, with cardiac syncope and advanced age presenting an increased risk of mortality.
- Recurrent syncope causes substantial secondary morbidity, including fall-related physical injury, psychological distress, functional decline, and greater daily dependency.
- Existing disease-focused diagnostic and therapeutic guidelines fail to address the complexity of syncope in frail older patients, necessitating integrated medical, functional, cognitive, and psychosocial evaluations.
Structured PICO
PPopulationElderly patients presenting with syncope, unexplained falls, or dizziness
IInterventionComprehensive geriatric assessment (multidimensional interdisciplinary diagnostic process focusing on medical, psychological, and functional capacity)
A comprehensive geriatric approach is recommended for managing syncope in elderly patients due to its multifactorial etiology, atypical presentations, and complex interactions with falls and frailty.