Objective: To compare one-year mortality risk associated with syncope and unexplained fall in older adults with dementia. Methods: 522 patients (aged >65 years) with dementia and history of transient loss of consciousness and/or unexplained falls were evaluated. The diagnosis of syncope was based on European Society of Cardiology guidelines. A “Syncopal Fall” was defined in patients with an initial clinical presentation of unexplained fall, but a final diagnosis of syncope after complete assessment. A “Truly Unexplained Fall” was defined in patients with an initial clinical presentation of unexplained fall, in whom a diagnosis of syncope had been excluded after the diagnostic work-up. One-year follow-up was assessed by phone interview. Results: Follow-up data were available for 501 participants (mean age 83 ± 6 years, 65% female). After a mean follow-up of 324 ± 93 days, death from any cause was reported in 188 participants (24%). Advanced age, male sex, cognitive and functional impairment were associated with a higher mortality rate. Patients with “Truly Unexplained Falls” had a higher mortality risk compared with syncope and “Syncopal Fall”. A diagnosis of “Truly Unexplained Falls” remained an independent predictor of one-year all-cause mortality in multivariate model. Conclusions: We propose the novel diagnostic category of “Truly Unexplained Fall”, resulting from the application of syncope guidelines to subjects with unexplained falls. This condition in older adults with dementia is a predictor of one-year all-cause mortality. For this new high risk profile, we advice a comprehensive geriatric assessment focused on risk factors for fall, aimed at a possible improvement of prognosis.

Truly unexplained falls after evaluation for syncope: A new diagnostic entity with severe prognosis / Ungar, A.; Ceccofiglio, A.; Mussi, C.; Bo, M.; Rivasi, G.; Rafanelli, M.; Martone, A. M.; Bellelli, G.; Nicosia, F.; Riccio, D.; Boccardi, V.; Tonon, E.; Curcio, F.; Landi, F.; Abete, P.; Mossello, E.. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 0953-6205. - 98:(2022), pp. 93-97. [10.1016/j.ejim.2022.02.007]

Truly unexplained falls after evaluation for syncope: A new diagnostic entity with severe prognosis

Mussi C.;
2022

Abstract

Objective: To compare one-year mortality risk associated with syncope and unexplained fall in older adults with dementia. Methods: 522 patients (aged >65 years) with dementia and history of transient loss of consciousness and/or unexplained falls were evaluated. The diagnosis of syncope was based on European Society of Cardiology guidelines. A “Syncopal Fall” was defined in patients with an initial clinical presentation of unexplained fall, but a final diagnosis of syncope after complete assessment. A “Truly Unexplained Fall” was defined in patients with an initial clinical presentation of unexplained fall, in whom a diagnosis of syncope had been excluded after the diagnostic work-up. One-year follow-up was assessed by phone interview. Results: Follow-up data were available for 501 participants (mean age 83 ± 6 years, 65% female). After a mean follow-up of 324 ± 93 days, death from any cause was reported in 188 participants (24%). Advanced age, male sex, cognitive and functional impairment were associated with a higher mortality rate. Patients with “Truly Unexplained Falls” had a higher mortality risk compared with syncope and “Syncopal Fall”. A diagnosis of “Truly Unexplained Falls” remained an independent predictor of one-year all-cause mortality in multivariate model. Conclusions: We propose the novel diagnostic category of “Truly Unexplained Fall”, resulting from the application of syncope guidelines to subjects with unexplained falls. This condition in older adults with dementia is a predictor of one-year all-cause mortality. For this new high risk profile, we advice a comprehensive geriatric assessment focused on risk factors for fall, aimed at a possible improvement of prognosis.
2022
98
93
97
Truly unexplained falls after evaluation for syncope: A new diagnostic entity with severe prognosis / Ungar, A.; Ceccofiglio, A.; Mussi, C.; Bo, M.; Rivasi, G.; Rafanelli, M.; Martone, A. M.; Bellelli, G.; Nicosia, F.; Riccio, D.; Boccardi, V.; Tonon, E.; Curcio, F.; Landi, F.; Abete, P.; Mossello, E.. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 0953-6205. - 98:(2022), pp. 93-97. [10.1016/j.ejim.2022.02.007]
Ungar, A.; Ceccofiglio, A.; Mussi, C.; Bo, M.; Rivasi, G.; Rafanelli, M.; Martone, A. M.; Bellelli, G.; Nicosia, F.; Riccio, D.; Boccardi, V.; Tonon, ...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1265159
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