80ADULTS WITH SYNCOPE: SYNCOPE IN YOUTH AS A MODERATOR FOR RECENT SYNCOPE AND HEALTH OUTCOMES IN THE IRISH LONGITUDINAL STUDY ON AGEING

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Abstract

Introduction: Approximately 40% of the population will experience a faint; commonly due to vasovagal syncope (VVS). Syncope peaks between 17 and 25 and again later in life when cardiac causes are common. VVS is considered benign—a physiological response to orthostatic or psychological stress rather than a pathophysiological condition. This study examined clinical correlates of syncope and explored whether syncope in youth affects the relationship between recent syncope and current health outcomes—self-reported health (SRH), disabilities, quality-of-life (QoL), depression, anxiety, memory and fear of falling.

Methods: Data are from a population-based sample [the Irish Longitudinal Study on Ageing (TILDA)] of community-dwelling adults aged 50 and older (n = 8,149). Syncope was assessed with the self-reported history: ‘have you ever fainted’ (3.9%); number of episodes in the past year (range 1–83) and fainters were asked to recall whether they fainted in youth (22.3%). Multivariate regression models were used controlling for; sex, education, age and comorbidities.

Results: The majority of lifetime fainters were female (72.9%), did not differ in age [non-fainters (mean = 62.0) versus lifetime fainters (mean = 63.5)] and half (52.9%) had at least one comorbidity. Multivariate regression results suggested adults with recent syncope had worse depression, SRH, day-to-day memory, lower QoL, were more fearful of falling, absent minded and more limitations (IADLs and ADLs). Youth syncope was associated with worse anxiety. Finally, syncope in youth moderated the relationship between recent syncope, SRH and depression in relation to multiple syncopal episodes. Multiple fainters with no youth syncope had worse depression (B = −6.72, P < 0.001) and worse SRH (B = 0.19, P = 0.001), than multiple fainters with youth syncope.

Conclusion: Results suggest that the effects of syncope on health outcomes are detrimental and syncope in youth can have lifelong impact. When designing interventions to improve health outcomes, both syncope history and number of recent episodes should be considered.

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