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

Background: 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. Aim of the study: 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. Materials and methods: 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). Results: 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). Conclusion: 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.