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Dysrhythmia and occult syncope as an explanation for falls in older patients
  1. Shamai A Grossman
  1. Correspondence to Dr Shamai A Grossman, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, One Deaconess Road, Boston MA 02215, USA; sgossma{at}bidmc.harvard.edu

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As life expectancy increases and the geriatric population expands dramatically, falls have become a more substantial health risk. According to the US Center for Disease Control, falls are already the leading cause of injury-related death among Americans aged 65 years and older.1 The consequences of a fall include death and immediate incapacitating injuries such as hip fractures, and also a decline in functional status, nursing home placement and a higher usage of medical resources.2

The WHO has focused on eliminating the preventable causes of falls as one of the highest priorities in healthcare prevention for the 21st century.3 At the same time, efforts to reduce the cost of medical care by eliminating non-diagnostic medical testing and an increasing emphasis on implementing evidence-based medicine argue for more discriminate testing when evaluating falls.

The first step in reducing the number of falls is understanding the aetiology of unexplained falls. Cerebral …

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