Syncope and Unexplained Falls in Elders with Dementia

Unexplained falls and transient loss of consciousness pose diagnostic challenges in older patients with dementia. In this prospective Italian study, researchers sought to determine the cause of unexplained falls or suspected syncope in 357 patients with dementia (mean age, 84) who were referred to special geriatric units. A standardized evaluation included comprehensive history-taking and physical examination, electrocardiography, orthostatic blood pressure measurement, and — in selected cases — echocardiography, Holter monitoring, carotid sinus massage, and tilt testing. These evaluations conformed to European Society of Cardiology guidelines (Eur Heart J 2009; 30:2631).

A plausible cause of syncope was identified in 158 of 181 patients ref…