title: The "syncope and dementia" study: a prospective, observational, multicenter study of elderly patients with dementia and episodes of "suspected" transient loss of consciousness.
abstract: OBJECTIVE
  Syncope and related falls are one of the main causes and the predominant cause of hospitalization in elderly patients with dementia. However, the diagnostic protocol for syncope is difficult to apply to patients with dementia. Thus, we developed a "simplified" protocol to be used in a prospective, observational, and multicenter study in elderly patients with dementia and transient loss of consciousness suspected for syncope or unexplained falls. Here, we describe the protocol, its feasibility and the characteristics of the patients enrolled in the study.
  
  
  METHODS
  Patients aged ≥65 years with a diagnosis of dementia and one or more episodes of transient loss of consciousness during the previous 3 months, subsequently referred to a Geriatric Department in different regions of Italy, from February 2012 to May 2014, were enrolled. A simplified protocol was applied in all patients. Selected patients underwent a second-level evaluation.
  
  
  RESULTS
  Three hundred and three patients were enrolled; 52.6% presented with episodes suspected to be syncope, 44.5% for unexplained fall and 2.9% both. Vascular dementia had been previously diagnosed in 53.6% of participants, Alzheimer's disease in 23.5% and mixed forms in 12.6%. Patients presented with high comorbidity (CIRS score = 3.6 ± 2), severe functional impairment, (BADL lost = 3 ± 2), and polypharmacy (6 ± 3 drugs).
  
  
  CONCLUSIONS
  Elderly patients with dementia enrolled for suspected syncope and unexplained falls have high comorbidity and disability. The clinical presentation is often atypical and the presence of unexplained falls is particularly frequent.
authors.affiliation: Syncope Unit, Geriatric Cardiology and Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Viale Pieraccini 6, 50139, Florence, Italy. aungar@unifi.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ungar
authors.affiliation: Centro di Valutazione e Ricerca Gerontologica, Chair of Geriatrics, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mussi
authors.affiliation: Medicine and Geriatric Unit, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Nicosia
authors.affiliation: Syncope Unit, Geriatric Cardiology and Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Viale Pieraccini 6, 50139, Florence, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Ceccofiglio
authors.affiliation: Acute Geriatric Unit, Department of Health Sciences, San Gerardo Hospital, University of Milano Bicocca, Monza, Italy.|Milan Center for Neuroscience (Neuro-Mi), Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellelli
authors.affiliation: SCDU Geriatria e Malattie Metaboliche dell'Osso, Città della Salute e della Scienza-Molinette-Torino, Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Bo
authors.affiliation: Geriatric Department, SS. Trinità Hospital, Cagliari, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Riccio
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Landi
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Martone
authors.affiliation: Division of Geriatrics, Ospedale "S. Maria di Ca' Foncello", Treviso, Italy.
authors.forename: Assunta
authors.initials: A
authors.lastname: Langellotto
authors.affiliation: Centro di Valutazione e Ricerca Gerontologica, Chair of Geriatrics, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ghidoni
authors.affiliation: Geriatric Unit, Santa Chiara Hospital, Trento, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Noro
authors.affiliation: Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000150:complications / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D013575:Syncope / Q000453:epidemiology / Q000209:etiology
keywords: Dementia; Falls; Orthostatic hypotension; Syncope