Elsevier

Progress in Cardiovascular Diseases

Volume 55, Issue 4, January–February 2013, Pages 357-363
Progress in Cardiovascular Diseases

Epidemiology of Syncope/Collapse in Younger and Older Western Patient Populations

https://doi.org/10.1016/j.pcad.2012.11.006Get rights and content

Abstract

Syncope is a common problem which can be remarkably debilitating and associated with high health care costs; its true incidence is difficult to estimate due to variation in definition, differences in population prevalence and under reporting in the general population. The median peak of first syncope is around 15 years with a sharp increase after 70 years. Vasovagal syncope is the commonest cause of syncope for all age groups, but cardiac causes become more common with advancing age. The cumulative incidence of syncope ranges from 5% in females aged 20 to 29, up to 50% in females aged 80 and above. One-third of medical students report at least one syncopal episode in their life-time. The life-time cumulative incidence of syncope in women is almost twice that of men. Syncope accounts for up to 1–3% of hospital admissions and Emergency Room (ER) visits and in these settings is associated with cardiovascular co-morbidity and cardiovascular pharmacotherapy. In older adults syncope is a major cause of morbidity and mortality with enormous personal and wider health economic costs. Prevalence and incidence figures for syncope in older adults are confounded by an overlap with presentations classified as falls. In addition to injury and increasing dependency, quality-of-life studies consistently show that functional impairment in persons with recurrent syncope is similar to other chronic diseases.

Section snippets

Syncope and the Framingham studies

The Framingham series illustrates this difficulty of comparisons for the epidemiology of syncope vis-à-vis variations in definitions and methodologies. For example, in the first Framingham cohort of 1985 the authors reported a first syncope episode in 3% of men and 3.5% of women over a 26-year follow up period (mean age of cohort was 46 ranging from 30 to 62 years). Of these, the majority had experienced an isolated syncope.5

The cumulative incidence of syncope during a 4-year follow-up in the

Conclusion

In conclusion, syncope is a common problem in the general population. Its age distribution is bi-modal or tri-modal according to recent studies, peaking in teenagers and the elderly. Although several studies have been performed with young subjects, the incidence of syncope in the elderly in the general population is less well studied, with the exception of the recent TILDA dataset.

The lifetime cumulative incidence of syncope is much higher in women than in men. Reflex syncope remains more

Statement of Conflict of Interest

The authors of this article have no pertinent conflicts of interest to report.

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    Statement of Conflict of Interest: see page 362.

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