Vasovagal syncope in the older person: differences in presentation between older and younger patients | Age and Ageing

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class="journal-info__format-label">Journal Article</span> </div> <div class="widget-items"> <div class="title-wrap"> <h1 class="wi-article-title article-title-main accessible-content-title at-articleTitle"> Vasovagal syncope in the older person: differences in presentation between older and younger patients <i class='' title='' ></i> </h1> <a href="#no-access-message" class="get-access get-access-jumplink at-get-access-jumplink js-no-access-jumplink"> <span class="get-access-text">Get access</span> <img class='get-access-icon' src='/UI/app/svg/chevron-right-white.svg' alt='Arrow' aria-hidden='true'> </a> </div> <div class="wi-authors at-ArticleAuthors"> <div class="al-authors-list"> <span class="al-author-name-more js-flyout-wrap"> <button type="button" class="linked-name js-linked-name-trigger btn-as-link">Gordon W. Duncan</button><span class='delimiter'>, </span> <span class="al-author-info-wrap arrow-up"> <div class="info-card-author authorInfo_OUP_Abstract_ArticleTop_Info_Widget"> <div class="name-role-wrap"> <div class="info-card-name"> Gordon W. Duncan <span class="info-card-footnote"><span class="xrefLink" id="jumplink-d205920e122"></span><a href="javascript:;" reveal-id="d205920e122" data-open="d205920e122" class="link link-ref link-reveal xref-default"></a></span> </div> </div> <div class="info-card-affilitation"> <div class="aff"><div class="addr-line">Falls and Syncope Service and Institute for Ageing and Health</div>, <div class="institution">Newcastle University, Royal Victoria Infirmary</div>, <div class="addr-line">Queen Victoria Road, Newcastle upon Tyne NE1 4LP</div>, <div class="country">UK</div></div> </div> <div class="info-author-correspondence"> <div content-id="d205920e122">Address correspondence to: S. W. Parry. Tel: +44 191 282 5237; Fax: +44 191 222 7628. Email: <a href="mailto:steve.parry@nuth.nhs.uk" target="_blank">steve.parry@nuth.nhs.uk</a></div> </div> <div class="info-card-search-label"> Search for other works by this author on: </div> <div class="info-card-search info-card-search-internal"> <a href="/ageing/search-results?f_Authors=Gordon+W.+Duncan" rel="nofollow">Oxford Academic</a> </div> <div class="info-card-search info-card-search-pubmed"> <a href="http://www.ncbi.nlm.nih.gov/pubmed?cmd=search&term=Duncan G">PubMed</a> </div> <div class="info-card-search info-card-search-google"> <a href="http://scholar.google.com/scholar?q=author:%22Duncan Gordon W.%22">Google Scholar</a> </div> </div> </span> </span> <span class="al-author-name-more js-flyout-wrap"> <button type="button" class="linked-name js-linked-name-trigger btn-as-link">Maw Pin Tan</button><span class='delimiter'>, </span> <span class="al-author-info-wrap arrow-up"> <div class="info-card-author authorInfo_OUP_Abstract_ArticleTop_Info_Widget"> <div class="name-role-wrap"> <div class="info-card-name"> Maw Pin Tan </div> </div> <div class="info-card-affilitation"> <div class="aff"><div class="addr-line">Falls and Syncope Service and Institute for Ageing and Health</div>, <div class="institution">Newcastle University, Royal Victoria Infirmary</div>, <div class="addr-line">Queen Victoria Road, Newcastle upon Tyne NE1 4LP</div>, <div class="country">UK</div></div> </div> <div class="info-card-search-label"> Search for other works by this author on: </div> <div class="info-card-search info-card-search-internal"> <a href="/ageing/search-results?f_Authors=Maw+Pin+Tan" rel="nofollow">Oxford Academic</a> </div> <div class="info-card-search info-card-search-pubmed"> <a href="http://www.ncbi.nlm.nih.gov/pubmed?cmd=search&term=Tan M">PubMed</a> </div> <div class="info-card-search info-card-search-google"> <a href="http://scholar.google.com/scholar?q=author:%22Tan Maw Pin%22">Google Scholar</a> </div> </div> </span> </span> <span class="al-author-name-more js-flyout-wrap"> <button type="button" class="linked-name js-linked-name-trigger btn-as-link">Julia L. Newton</button><span class='delimiter'>, </span> <span class="al-author-info-wrap arrow-up"> <div class="info-card-author authorInfo_OUP_Abstract_ArticleTop_Info_Widget"> <div class="name-role-wrap"> <div class="info-card-name"> Julia L. 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Parry</button><span class='delimiter'></span> <span class="al-author-info-wrap arrow-up"> <div class="info-card-author authorInfo_OUP_Abstract_ArticleTop_Info_Widget"> <div class="name-role-wrap"> <div class="info-card-name"> Steve W. 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>Abstract</h2> <section class="abstract"><p class="chapter-para"><strong>Background</strong><strong>:</strong> vasovagal syncope (VVS) has been diagnosed with increasing frequency in older people since the description of the head-up tilt table test (HUTT). There is, however, a paucity of research describing the clinical features of VVS in this group. To address this issue, we investigated the age distribution and differences in clinical characteristics associated with age in patients diagnosed with VVS by HUTT at our tertiary referral centre.</p><p class="chapter-para"><strong>Methods</strong><strong>:</strong> 1,060 consecutive patients with tilt-positive VVS were identified from a prospective database containing the demographic and clinical information of individuals assessed in our unit over a 10-year period. VVS was diagnosed with appropriate haemodynamic changes during HUTT and accompanying symptom reproduction.</p><p class="chapter-para"><strong>Results</strong><strong>:</strong> we found a bimodal age distribution with a small peak at 20–29 years and a larger peak at 70–79 years. Patients aged ≥60 years were less likely to report total loss of consciousness [odds ratio (OR) 0.50, 95% confidence interval (CI) = 0.38–0.64], near loss of consciousness (OR 0.53, 95% CI = 0.40–0.70) or palpitations (OR 0.45, 95% CI = 0.28–0.72) and more likely to present with unexplained falls (OR 2.33, 95% CI = 1.36–4.32). The typical provoking factors of prolonged standing (OR 0.55, 95% CI = 0.40–0.72), posture change (OR 0.61, 95% CI = 0.46–0.82) and hot environments (OR 0.57, 95% CI = 0.42–0.78) were also less common in older patients.</p><p class="chapter-para"><strong>Conclusion</strong><strong>:</strong> in our large study population, VVS was more common in older patients. The clinical presentation differed significantly between the two groups. Older patients were less likely to give a typical history and therefore clinicians need to have a high index of suspicion when evaluating the older patient presenting with collapse or unexplained falls.</p></section> <div class="article-metadata-panel clearfix at-ArticleMetadata"></div> <div class="kwd-group"><a class="kwd-part kwd-main" href="javascript:;" data-keyword="vasovagal">vasovagal</a>, <a class="kwd-part kwd-main" href="javascript:;" data-keyword="syncope">syncope</a>, <a class="kwd-part kwd-main" href="javascript:;" data-keyword="falls">falls</a>, <a class="kwd-part kwd-main" href="javascript:;" data-keyword="elderly">elderly</a></div>  <div class="widget widget-ArticlePubStateInfo widget-instance-OUP_ArticlePubStateInfo"> </div> <div class="article-metadata-standalone-panel clearfix"></div> <div class="copyright-statement custom-symbol">© Oxford University Press 2010</div> <span id="UserHasAccess" data-userHasAccess="False"></span> </div> </div> </div> <div class="widget 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Vasovagal syncope in the older person: differences in presentation between older and younger patients | Age and Ageing | Oxford Academic