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Q J Med 1985; 55: 45-54
© 1985 Association of Physicians

other

Syncope in an Elderly, Institutionalised Population: Prevalence, Incidence, and Associated Risk

LEWIS A. LIPSITZ, JEANNE Y. WEI and JOHN W. ROWE

Hebrew Rehabilitation Center for Aged; Joint Department of Medicine of Beth Israel and Brigham and Women's Hospitals; the Charles A. Dana Research Institute and Harvard-Thorndike Laboratory of Beth Israel Hospital; Division on Aging, Harvard Medical School; and Geriatric Research Education Clinical Center, West Roxbury/Brockton Veterans Administration Medical Center Boston, MA

Lewis A.Lipsitz,MD,Hebrew Rehabilition Centre for Aged,1200 centre street,Bostom(Roslindale),MA 02131

Accepted for publication 25 September 1984.

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 years) institutionalised patients revealed a 10 year prevalence of 23 per cent and one year incidence of 7 per cent. A two-year prospective follow-up of this population revea1çd a yearly incidence of 6 per cent and recurrence rate of 30 per cent. Of 67 patients who developed syncope during follow-up, a cause was established in 46; 14 (21 per cent) had cardiac and 32 (48 per cent) had non-cardiac aetiologies. Twenty-one cases (31 per cent) 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 with out the development of syncope, but two year rates of hospitalisation and death were not different between the two groups. Life-table survival analysis showed no difference in the mortality of subgroups with cardiac, non-cardiac, and unknown aetiologies of syncope. Syncope is common in multiply impaired elders and is likely a manifestation of co-morbid disease rather than an independent contributor to mortality.


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