Key result
Recurrent syncope in older adults linked to ~6.5-fold higher odds of cognitive impairment.
Why the study?
Recurrent syncope in the elderly causes repeated reductions in cerebral blood flow that can predispose patients to progressive neurodegeneration and functional decline, motivating evaluation of its common causes and associations with geriatric syndromes.
Is recurrent syncope associated with cognitive impairment and other geriatric syndromes in adults aged 75 years and older compared with age- and sex-matched controls?
Case-Control (n=100)
No
Is recurrent syncope associated with cognitive impairment and other geriatric syndromes in adults aged 75 years and older compared with age- and sex-matched controls?
In patients aged ≥75 years, recurrent syncope is predominantly driven by cardiac arrhythmias and valvular disease (especially aortic stenosis) and is strongly associated with cognitive impairment, multimorbidity, and hearing loss.
Answers are grounded in this paper and cite their sources.
Supports geriatric assessment in recurrent syncope; hypothesis-generating and requires prospective confirmation before clinical adoption.
Objective Syncope is a common clinical condition in the elderly, associated with significant morbidity and risk of recurrence. Recurrent syncope causing a repeated reduction in the cerebral blood flow can predispose to progressive neurodegeneration, a decline in overall health and functionality. Hence, this study was conducted to study the common causes of recurrent syncope and its association with various geriatric syndromes. Methodology This case–control study recruited 50 cases of recurrent syncope and 50 controls, aged 75 years and older. A detailed history and sequential evaluation for aetiologies of recurrent syncope were done. Cognition, frailty, activities of daily living, depression, and nutrition were assessed using various scales. Results Most (80%, 80/100) of the participants were males and the mean age was 80.04 ± 4.3 years. In the syncope group, 42% (21/50) of patients had arrhythmia, and 30% (15/30) had valvular heart disease. Recurrent syncope was significantly associated with lower scores on Montreal cognitive assessment scale (OR: 6.47 P < 0.001), four or more comorbidities (OR: 6.29 P < 0.001), and hearing impairment (OR: 6.21 P < 0.004) on multivariate logistic regression analysis. Conclusion Recurrent syncope is significantly associated with cognitive impairment, the presence of four or more comorbidities, and hearing impairment. Conduction abnormality was the most common etiology of recurrent cardiovascular syncope. Structured evaluation and appropriate management of recurrent syncope might reduce the decline in physical, cognitive, and psychological reserve. A follow‐up longitudinal study is needed to establish this.
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Bandhu et al. (2023) conducted a case-control in Recurrent syncope in older adults (n=100). Recurrent syncope vs. Age- and sex-matched controls without a history of syncope was evaluated on Cognitive impairment (Montreal Cognitive Assessment score <26) (OR 6.47, 95% CI 2.21-18.91, p=0.001). Recurrent syncope in patients aged ≥75 years was independently associated with cognitive impairment, ≥4 comorbidities, and hearing impairment.
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