Causes of fainting in elderly people. Understanding Syncope in the Elderly: Causes, Risks, and Prevention
What are the main causes of syncope in older adults. How does orthostatic hypotension contribute to fainting episodes. Why is heart disease a significant factor in elderly syncope. Can medication interactions lead to fainting in seniors. How does dehydration affect blood pressure and consciousness in the elderly. Are there neurological conditions that may cause syncope in older people. What steps can be taken to prevent syncope-related falls in the elderly.
The Nature and Prevalence of Syncope in Older Adults
Syncope, commonly known as fainting, is a temporary loss of consciousness caused by reduced blood flow to the brain. While it can affect people of all ages, syncope becomes increasingly prevalent among older adults. This heightened occurrence is primarily due to age-related changes in the body’s ability to regulate blood pressure and maintain adequate cerebral perfusion.
As individuals age, their bodies become less adept at compensating for sudden changes in blood pressure or heart rate. This vulnerability makes older adults more susceptible to syncope episodes, which can have serious consequences, including falls and injuries.
Why is syncope more common in the elderly?
- Decreased cardiovascular responsiveness
- Multiple medical conditions
- Polypharmacy (use of multiple medications)
- Age-related changes in blood pressure regulation
- Reduced fluid intake and dehydration risk
Orthostatic Hypotension: A Leading Cause of Elderly Syncope
Orthostatic hypotension, a sudden drop in blood pressure upon standing, is one of the most common causes of syncope in older adults. This condition occurs when the body fails to adequately adjust blood pressure in response to positional changes, leading to reduced cerebral blood flow and potential loss of consciousness.
What factors contribute to orthostatic hypotension in seniors?
Several factors can contribute to orthostatic hypotension in the elderly population:
- Medications: Certain drugs, particularly those used to treat hypertension, can exacerbate orthostatic hypotension.
- Postprandial hypotension: A drop in blood pressure after eating, which is more common in older adults.
- Dehydration: Inadequate fluid intake or excessive fluid loss can lead to decreased blood volume and orthostatic hypotension.
- Autonomic dysfunction: Age-related changes in the autonomic nervous system can impair blood pressure regulation.
Managing orthostatic hypotension often involves a combination of lifestyle modifications, medication adjustments, and in some cases, the use of compression stockings or abdominal binders to improve venous return.
Reflex Syncope and Its Impact on Older Adults
Reflex syncope, also known as neurally mediated syncope, is another significant cause of fainting episodes in the elderly. This type of syncope occurs when the body overreacts to certain triggers, leading to a sudden drop in heart rate and blood pressure.
How does carotid sinus syndrome contribute to reflex syncope?
Carotid sinus syndrome is a condition where the pressure sensors in the carotid arteries become hypersensitive. In older adults, this can lead to an exaggerated response to stimuli such as:
- Tight collars or neckties
- Rapid head and neck movements
- Certain medications
When triggered, the carotid sinus syndrome can cause a sudden drop in heart rate and blood pressure, resulting in syncope. Diagnosis typically involves specific testing, and management may include avoiding triggers and, in some cases, the use of medications or pacemakers.
Cardiovascular Causes of Syncope in the Elderly
Heart-related problems are a significant concern when it comes to syncope in older adults. Cardiovascular causes of syncope can be particularly serious and may indicate underlying heart disease that requires prompt medical attention.
What cardiac conditions can lead to syncope in seniors?
Several cardiac conditions can contribute to syncope in the elderly population:
- Aortic stenosis: Narrowing of the aortic valve can restrict blood flow from the heart, leading to reduced cerebral perfusion and syncope.
- Arrhythmias: Irregular heart rhythms, particularly bradycardia (slow heart rate), are common cardiac causes of syncope in older adults.
- Heart failure: Impaired cardiac function can lead to inadequate blood flow to the brain, resulting in syncope.
- Myocardial infarction: A heart attack can cause syncope as a symptom of reduced cardiac output.
Cardiac syncope often requires comprehensive evaluation, including electrocardiograms, echocardiograms, and in some cases, implantable loop recorders to identify the underlying cause and guide appropriate treatment.
Neurological Conditions and Their Role in Elderly Syncope
While less common than cardiovascular causes, neurological conditions can also contribute to syncope in older adults. These conditions often affect the brain’s ability to regulate blood flow or the nervous system’s control over heart rate and blood pressure.
Which neurological disorders are associated with syncope in the elderly?
Several neurological conditions can manifest with syncope or syncope-like episodes in older adults:
- Stroke or transient ischemic attack (TIA)
- Cerebrovascular disease
- Autonomic neuropathy
- Parkinson’s disease
- Multiple system atrophy
These conditions may present with additional symptoms such as dizziness, visual disturbances, bladder control issues, or chronic fatigue. A thorough neurological evaluation is crucial for accurate diagnosis and appropriate management of syncope related to these disorders.
The Impact of Dehydration on Syncope Risk in Seniors
Dehydration is a significant yet often overlooked factor contributing to syncope in older adults. As individuals age, their ability to sense thirst diminishes, and kidney function may decline, making them more susceptible to dehydration.
How does dehydration increase the risk of syncope in the elderly?
Dehydration can lead to syncope through several mechanisms:
- Reduced blood volume: Dehydration decreases overall blood volume, which can lead to inadequate cerebral perfusion.
- Orthostatic hypotension: Lack of fluid exacerbates the body’s inability to maintain blood pressure when changing positions.
- Electrolyte imbalances: Dehydration can disrupt the balance of essential electrolytes, affecting heart rhythm and blood pressure regulation.
- Increased blood viscosity: Thicker blood due to dehydration can impair circulation and oxygen delivery to the brain.
Preventing dehydration-related syncope involves encouraging regular fluid intake, monitoring urine output and color, and educating older adults and caregivers about the importance of hydration, especially during hot weather or illness.
Medication-Related Syncope in Older Adults
Polypharmacy, the use of multiple medications, is common among older adults and can significantly increase the risk of syncope. Drug interactions and side effects can affect blood pressure, heart rate, and overall cardiovascular function, potentially leading to fainting episodes.
Which medications are most likely to cause syncope in the elderly?
Several classes of medications are known to increase the risk of syncope in older adults:
- Antihypertensives: Drugs used to treat high blood pressure can sometimes lower it too much, especially when changing positions.
- Diuretics: These medications can lead to dehydration and electrolyte imbalances, increasing syncope risk.
- Antidepressants: Some antidepressants can cause orthostatic hypotension as a side effect.
- Antiarrhythmics: Medications used to treat irregular heart rhythms may sometimes exacerbate bradycardia.
- Vasodilators: These drugs can cause excessive blood vessel dilation, leading to drops in blood pressure.
Healthcare providers should regularly review medication regimens in older adults, considering potential interactions and side effects that may contribute to syncope risk. Adjusting dosages or finding alternative treatments may be necessary to reduce the likelihood of medication-related syncope.
Preventing Syncope-Related Falls and Injuries in the Elderly
Syncope-related falls pose a significant risk to older adults, potentially leading to serious injuries, loss of independence, and decreased quality of life. Implementing strategies to prevent syncope and reduce fall risk is crucial for maintaining the health and well-being of seniors.
What measures can be taken to prevent syncope and associated falls in older adults?
Several approaches can help minimize the risk of syncope and related falls in the elderly population:
- Regular medical check-ups: Frequent evaluations can help identify and address underlying health conditions that may contribute to syncope.
- Medication management: Regular review and adjustment of medications can help reduce the risk of drug-related syncope.
- Hydration awareness: Educating older adults and caregivers about the importance of adequate fluid intake can prevent dehydration-related syncope.
- Environmental modifications: Removing tripping hazards and installing grab bars or handrails can reduce fall risk during syncopal episodes.
- Exercise programs: Tailored physical activity can improve cardiovascular health and balance, potentially reducing syncope risk.
- Compression stockings: These can help improve venous return and reduce orthostatic hypotension in some individuals.
- Lifestyle adjustments: Teaching techniques such as leg crossing or hand clenching before standing can help maintain blood pressure.
Implementing a comprehensive fall prevention strategy that addresses both syncope risk factors and environmental hazards is essential for protecting older adults from syncope-related injuries.
By understanding the various causes of syncope in the elderly and taking proactive measures to address these risk factors, healthcare providers, caregivers, and older adults themselves can work together to reduce the incidence of fainting episodes and their potentially serious consequences. Regular medical supervision, lifestyle modifications, and environmental adaptations all play crucial roles in maintaining the health and safety of seniors prone to syncope.
Causes – Causes | American Geriatrics Society
Syncope is usually caused by a temporary decrease of blood flow to your brain. Syncope is not considered a disease in itself, but instead a symptom of one or more possibly serious conditions. Some of the possible causes are essentially harmless. However, some can be life-threatening. Often times, syncope can be due to many different causes.
In older adults, the most common causes of syncope are orthostatic hypotension, reflex syncope, and heart disease.
Orthostatic Hypotension
Orthostatic hypotension is the medical term for a sudden drop in blood pressure. It’s common to occasionally feel lightheaded when you stand up suddenly, but if this happens frequently or results in fainting, it may mean that your body has trouble maintaining a healthy blood pressure. Orthostatic hypotension can be caused by:
- Medications, often those used to treat high blood pressure.
- A drop in blood pressure immediately after eating. (This is called postprandial hypotension.)
Reflex Syncope
Reflex syncope is usually a side effect of carotid sinus syndrome, a condition where the pressure sensors in one of the carotid arteries in your neck are hypersensitive. You may make this condition worse if you wear clothing with tight collars, turn your head and neck too quickly, or take certain medications. Your healthcare provider will do specific testing to determine if this is the cause of the syncope.
Heart Disease
Syncope that is associated with heart problems can be serious. It can be caused by:
- Narrowing of the aortic heart valve (called aortic stenosis)
- Irregular heart rhythms
- Syncope can be particularly caused by an unusually low heart rate (also called bradycardia). Bradycardia (a heart rate less than 60 beats per minute) is the most common cardiac cause of syncope in older adults.
- Heart failure
- Heart attack
Other Causes
- Conditions of the brain or nervous system
- This includes strokes or narrowing of the blood vessels in the brain. Aside from syncope, some other signs of these conditions include dizziness, visual problems, loss of bladder control, inability to sweat, difficulty tolerating the heat, constipation, chronic fatigue, or erectile dysfunction.
- Dehydration
- As you age, your kidneys don’t function as well as they used to, and you don’t always drink enough liquids. This can lead to dehydration and a drop in blood volume, which can lower your blood pressure.
- As you age, your thirst mechanism does not work as well as it used to, and your body does not tell you when you are becoming dehydrated. This can result in a drop in blood volume without you realizing that you should drink something.
- Medications
- Polypharmacy is the use of several different medications for different conditions. Polypharmacy can lead to syncope due to drug interactions and adverse effects. Your healthcare provider will review your list of prescribed and over-the-counter medications to see if any may be related to an episode of syncope.
Last Updated June 2020
Syncope and Falls in the Elderly (SaFE)
Syncope and Falls in the Elderly (SaFE)
“I never realised that I was losing consciousness. Each time I found myself on the ground I thought I had tripped” – Patient
This advisory area has been put together to provide information and advice to older adults, their families, carers, care workers and medical professionals on syncope. The information is aimed at increasing awareness and understanding of syncope and providing better support specifically for older adults who experience blackouts unexplained falls or who are diagnosed with syncope.
Dr Matt Fay, GP with special interest in cardiology, discusses the diagnosis and treatment of syncope in older adults
What is Syncope?
Syncope is the medical term for a faint that is caused by a reduction in blood supply to the brain, due either to a diversion of blood away from the brain or to a heart problem). As we get older, the prevalence of syncope increases as our bodies are less able to deal with falls in blood pressure as the body’s mechanisms slow over the years. Syncope is also more difficult to diagnose in older people because there are often multiple causes. (Please click on the video link for information on syncope in older people from STARS Patron Professor Rose Anne Kenny).
Syncope causes falls
One of the major concerns with syncope is the potential injury that may be sustained during the fall which is often caused by a faint. There are many risk factors causing falls in older people. External causes, such as badly fitting slippers cause 50% of falls in older people. Orthostatic intolerance is one of the major causes for the other 50% of falls. Up to half of the residents of nursing homes fall each year, and as many as 40% of them fall more than once.
Misdiagnosis
30% of patients aged 65 years and over who have experienced syncope will not be aware that they have fainted, they instead will report that they have fallen. This is due to a brief loss of memory in the time just before losing consciousness (medically termed retrograde amnesia). As a consequence, doctors may be likely to diagnose a mechanical fall and patients will not be investigated for the actual cause, such as low blood pressure, or an arrhythmia (irregular, too fast or too slow heart rhythm). Unfortunately this may leave the loss of consciousness untreated.
Syncope and Falls in the Elderly (SaFE) project
Aims for older people:
• to promote accurate diagnosis and treatment of syncope
• raise awareness of syncope as a cause of falls
• provide information and support
If more people are made aware of syncope as a cause of falls, the root cause could be treated and recurring falls prevented.
STARS has developed information and advice for older people with syncope. All information is approved by the STARS medical advisory committee and is endorsed by the Department of Health.
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Common Causes and Preventative
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Key facts on Syncope as a cause
of falls – for Medical Professionals
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What causes seniors to fall so frequently?
The question
I’m a 68-year-old male and I’ve collapsed twice, one time putting a big dent in my living room wall. Many times my thighs feel weak and I have a mild sense of vertigo while out shopping. A catscan confirms I do not have a brain tumour. Senior friends of mine have also collapsed at one time or another: some needing assistance to get up, and others needing stitches because of the fall.
What’s the cause of all these senior collapses?
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The answer
Syncopal episodes, or falling with a temporary loss of consciousness is a significant issue that can have potentially severe complications. Generally this is caused by a temporary decrease of the brain’s supply of blood which can be due to a change in blood pressure, lack of food or more serious causes such as heart or neurologic disease.
People of any age can faint, but older people more often have a serious underlying cause. The impact of collapsing can be significant both physically and emotionally. Falling accounts for approximately one half of deaths due to injury in the elderly, so I cannot overemphasize the importance of early investigation to potentially understand what may be the cause and work to put in place preventative strategies.
As we age, physical instability increases due to muscle weakening, arthritis, slowed reflexes, increased instability of blood pressure, and decreased vision. But falling is not a normal part of aging – you’re smart to be concerned.
In order to understand what may be causing these collapses in you and your friends – a thorough medical history investigation and physical examination is warranted. A CT scan is usually done to rule out stroke, injury or tumour suspected and while it is reassuring that your CT scan was normal, further investigations may be considered to understand why this has occurred twice.
Your doctor will want to know what you were doing prior to the episodes: were there any other associated symptoms prior to the episode? What medications are you taking at the time?
Potential causes of syncope can be divided into individual causes and environmental causes:
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Individual causes:
Cardiovascular conditions: Blood pressure fluctuations, arrhythmias (abnormal heart rhythms such as atrial fibrillation or rapid or slow heart beat) or abnormal heart structure such as valve dysfunction can all cause syncope. Your doctor may ask if you have other symptoms such as chest pain, palpitations (sensation of irregular heart beat) or shortness of breath preceding the collapse which may increase suspicion of a cardiovascular cause.
Neurologic conditions: While rare, it is important to discuss neurologic causes of syncope. The main one to consider is something called transient ischemic attack (TIA) where there may be decreased blood flow to the brain due to a blockage of blood flow through one of the main arteries to the brain. This may be accompanied by double vision, slurred speech and loss of balance. While seizure disorders are a concern, they generally have other accompanying symptoms such as post-collapse fatigue, incontinence and characteristic movements.
Medications: As we age, the number of medications we take increases, which in turn increases our experiences with side effects. A review of medications with your doctor or pharmacist may help identify some of these potential interactions.
Change in balance/walking: Musculoskeletal conditions such as arthritis and osteoporosis can affect balance and gait.
Postprandial fainting: Can occur in elderly people when blood pressure drops about an hour after eating.
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Postural syncope: A change in position – usually from lying down or sitting to standing – can cause a decrease in blood flow to brain secondary to a blood pressure drop leading to dizziness, weakness in the legs and can potentially cause collapse.
General conditions: Hypoglycemia (low blood sugar), dehydration, or infections such as pneumonia can cause weakness and increases the risk of collapse.
Environmental causes: Collapses may be due to environmental factors such as loose rugs, stairs and poor lighting.
Falls can be a warning sign of something more serious, and if they recur can lead to serious negative outcomes. Once you work through a potential list of causes with your doctor by having the appropriate investigations, you may be able to prevent further falls from occurring
Send family doctor Sheila Wijayasinghe your questions at [email protected]. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
Read more Q&As from Dr. Wijayasinghe.
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The content provided in The Globe and Mail’s Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.
Syncope (Fainting) | American Heart Association
Syncope is a temporary loss of consciousness usually related to insufficient blood flow to the brain. It’s also called fainting or “passing out.”
It most often occurs when blood pressure is too low (hypotension) and the heart doesn’t pump enough oxygen to the brain. It can be benign or a symptom of an underlying medical condition.
What causes syncope?
Syncope is a symptom that can be due to several causes, ranging from benign to life-threatening conditions. Many non life-threatening factors, such as overheating, dehydration, heavy sweating, exhaustion or the pooling of blood in the legs due to sudden changes in body position, can trigger syncope. It’s important to determine the cause of syncope and any underlying conditions.
However, several serious heart conditions, such as bradycardia, tachycardia or blood flow obstruction, can also cause syncope.
What is neurally mediated syncope?
Neurally mediated syncope (NMS) is the most common form of fainting and a frequent reason for emergency department visits. It’s also called reflex, neurocardiogenic, vasovagal (VVS) or vasodepressor syncope. It’s benign and rarely requires medical treatment.
NMS is more common in children and young adults, though it can occur at any age. It happens when the part of the nervous system that regulates blood pressure and heart rate malfunctions in response to a trigger, such as emotional stress or pain.
NMS typically happens while standing and is often preceded by a sensation of warmth, nausea, lightheadedness, tunnel vision or visual “grayout.” Placing the person in a reclining position restores blood flow and consciousness, and ends the seizure.
Situational syncope, which is a type of NMS, is related to certain physical functions, such as violent coughing (especially in men), laughing or swallowing.
Other disorders can cause syncope, which also can be a side effect of some medicines.
Some types of syncope suggest a serious disorder:
- Those occurring with exercise
- Those associated with palpitations or irregularities of the heart
- Those associated with family history of recurrent syncope or sudden death
What is cardiac syncope?
Cardiac or cardiovascular syncope is caused by various heart conditions, such as bradycardia, tachycardia or certain types of hypotension. It can increase the risk of sudden cardiac death.
People suspected of having cardiac syncope but who don’t have serious medical conditions may be managed as outpatients. Further inpatient evaluation is needed if serious medical conditions are present. Conditions that may warrant hospital evaluation and treatment include various cardiac arrhythmic conditions, cardiac ischemia, severe aortic stenosis and pulmonary embolism. If evaluation suggests cardiac vascular abnormalities, an ambulatory external or implantable cardiac monitor may be required.
Heart failure, atrial fibrillation and other serious cardiac conditions can cause recurrent syncope in older adults, with a sharp increase after age 70.
What are the risk factors?
Syncope is common, but adults over age 80 are at greater risk of hospitalization and death.
Younger people without cardiac disease but who’ve experienced syncope while standing or have specific stress or situational triggers aren’t as likely to experience cardiac syncope.
Cardiac syncope is a higher risk in: people older than age 60; men; presence of known heart disease; brief palpitations or sudden loss of consciousness; fainting during exertion; fainting while supine; an abnormal cardiac exam; or family history of inheritable conditions. Other existing conditions and medications used are particularly important in older patients.
AHA Recommendations
People who experience the warning signs of fainting of dizziness, nausea and sweaty palms should sit or lie down. Anyone with syncope should receive an initial evaluation, including detailed physical and history examinations and measurement of blood pressure and heart rate, by a physician.
An ECG (electrocardiogram) also is recommended as part of an initial evaluation to provide information about the cause of syncope. ECG is widely available and inexpensive and can provide information about the potential and specific cause of syncope (for example, abnormal heart rhythms). Other tests, such as exercise stress test, Holter monitor and an echocardiogram, may be needed to rule out other cardiac causes.
An ECG also is recommended for children and young adults with syncope. Other noninvasive diagnostic testing may be needed if they’re suspected of having congenital heart disease, cardiomyopathy or a heart rhythm disorder.
If the initial evaluation is unclear, it may be useful for patients to undergo a tilt test. The blood pressure and heart rate will be measured while lying on a board and with the board tilted up. People with NMS usually will faint during the tilt, due to the rapid drop in blood pressure and heart rate. When people are placed on their back again, blood flow and consciousness are restored.
Patients with VVS and without a serious medical condition usually can be managed in an outpatient setting. For older adults, a comprehensive approach in collaboration with a geriatric expert can be helpful.
For people who are dehydrated, it may be beneficial to increase their salt and fluid intake to prevent syncope. That recommendation – as well as the removal or reduction of hypotensive drugs and diuretics – also is encouraged when appropriate and safe for people who’ve experienced situational syncope.
Consuming more salt and fluids can benefit most pediatric patients, but the results are unclear in people with NMS. Other lifestyle changes, such as exercise, also can benefit pediatric patients.
Some patients of any age may need medication.
When it comes to driving after a syncope episode, there are no restrictions for VVS patients who had no fainting spells in the previous year. Still, it may be helpful for healthcare providers to discuss regional driving laws, restrictions and implications with all patients.
For athletes, a cardiovascular assessment by a healthcare provider is recommended before resuming competitive sports. Those with syncope and a structural heart rhythm disorder should also see a specialist. Extended monitoring may help athletes with unexplained exertional syncope.
The Future of Syncope
Standardized national registries and large databases are needed to gather more data to better understand the incidence and prevalence of syncope, patient risks and outcomes, set lifestyle policies and improve healthcare delivery.
Some studies have shown that with recurrent episodes of fainting, the quality of life is reduced in both adults and in pediatric patients, however more well designed studies that incorporates quality of life, work loss and functional capacity are needed. In addition, more studies incorporate quality of life, work loss and functional capacity as possible results and better understand the relationship of syncope symptoms, causes and underlying diseases to various outcomes.
Fainting | Syncope | Passing Out | Symptoms, Treatment and Causes
What happens when you faint?
When you faint, you become unconscious for a few seconds. It is also called passing out or blacking out. The medical term for this is syncope. You may feel sick and sweaty first or pass out with no warning at all.
When you pass out, you fall to the ground. It isn’t the same thing as a seizure which usually makes you jerk. You come around after a few seconds and feel back to normal. Some people feel very tired after they’ve come around. Usually, fainting happens for a reason, like when you’re in pain or have been standing for a long time in a hot place.
Fainting happens because the brain needs a constant supply of oxygen. If that supply falls below a certain level, we fall to the ground, which makes it easier for the more oxygen-rich blood to reach the brain.
How common is fainting?
Fainting is common at all ages and affects up to 4 in 10 people at least once in their lives. Most people never get medical help. Most people (95%) have their first attack of syncope before they’re 40 years old.
If you have it for the first time after 40, it is more likely to be due to a serious underlying problem. The most common cause is a common faint, also called neurally mediated syncope (NMS).
Common faints usually happen for the first time in teenage years and affect girls more than boys. In older people, fainting is more likely to be due to an underlying heart problem, low blood pressure or as a side-effect of medication.
What problems can cause fainting?
Here are some of the more common causes of faints:
Common faint (NMS): this is also known as vasovagal syncope. It is the most common cause of fainting. NMS can occur in various situations. These include:
- Fear.
- Severe pain or emotional distress.
- After extreme exercise.
- After prolonged standing, especially in hot places (which is why soldiers on parade may faint).
- When wearing tight collars that constrict the neck.
During attacks, you may look pale and feel sweaty. Your eyes will usually stay open.
Orthostatic hypotension: this is a fall in blood pressure on standing up, which can cause fainting. It can occur:
- Due to medication prescribed to lower blood pressure.
- During being sick (vomiting) or experiencing runny stools (diarrhoea) and other reasons for having a lack of fluid in the body (being dehydrated).
- As a result of neurological diseases such as Parkinson’s disease and peripheral neuropathy.
- After a big meal.
Cardiac syncope: this occurs due to an underlying heart problem. There may be a family history of sudden death. The faint may be preceded by chest pain or the sensation of having a ‘thumping heart’ (palpitations) and may happen during exercise.
What investigations might be advised?
The doctor will want to know more about what you were doing when you blacked out.
- You will be asked whether you’ve recently started new medication.
- Try to remember whether you had any warning before you blacked out.
- Did anyone see you fall? (If so, ask them to speak to the doctor if possible).
- How did you feel when you came around?
These details will help the doctor to make a diagnosis. Your doctor will examine you. They will check your heart, including your blood pressure when sitting and standing and your pulse. You may be asked to have a heart tracing (an electrocardiogram, or ECG). You may have blood tests for anaemia and diabetes. Further tests of your heart and nervous system may be necessary.
What else could it be?
The most common cause of blacking out is fainting. Other causes include epileptic seizures, syncope due to anxiety (psychogenic pseudosyncope) and other rare causes of faints.
Other causes of blacking out may be due to low blood sugar (hypoglycaemia) and lack of oxygen (hypoxia) from a variety of causes. It may be due to over-breathing (hyperventilation) but this is rare.
You may also black out after a fall or blow to the head or due to excess alcohol or street drugs.
Strokes and mini strokes (transient ischaemic attacks) can also result in a blackout.
Prolonged blackout, confusion after the event, incomplete recovery and tongue biting all suggest that the cause is not a simple faint.
Treatments for fainting and syncope
Treatment will depend on the likely cause of your blackout. You may be asked to keep a diary of your faints, including what you were doing when each happened. Most people will only need to see their GP but you may be referred for further investigation and treatment at a hospital.
What can you do if you feel like you’re going to faint?
- Lie down flat with your legs up on a chair or against a wall or sit down on the ground with your head between your knees. Do not just sit on a chair.
- Squatting down on your heels can be very effective and is less noticeable in public.
- When feeling better, get up carefully. If symptoms return, resume the position.
If you faint again:
- Discuss with your doctor stopping any medication that may be responsible.
- Avoid alcohol.
- Drink more fluids such as water or soft drinks.
- Wear support stockings.
- Do leg crossing and arm tensing exercises.
Driving and faints
The Driver and Vehicle Licensing Agency (DVLA) does not have to be informed of a simple faint but greater restrictions apply if the situation is more complicated or if diagnosis is less clear.
If in doubt, contact the DVLA.
What should you do next?
You should call an ambulance if you:
- Have a blackout while exercising or lying down.
- Have a family history of sudden and unexplained deaths.
- Experience chest pain or the sensation of a ‘thumping heart’ (palpitations).
If the attack happens again or you do not feel completely back to normal, you should also seek urgent medical attention. In all other cases, you should see your GP. If you have lots of attacks, or you hurt yourself because of the faints, your GP may want you to see a specialist. They may also want you to see a specialist if your faints could affect your driving.
How can I avoid faints?
You will need to find the underlying cause and try to address it if possible. Common faints are by far the most common cause. Many people who faint know when it tends to happen and how to avoid attacks.
What is the outlook?
Outlook (prognosis) depends on the underlying cause but is generally very good. In young people, when the blackouts are not associated with any heart or nervous system problem, there is nothing to worry about. In older people, there may be a risk to their health but this is due to the underlying condition and the risks from falling.
What to Do When a Senior Faints and Falls
People 70 years and older are twice as likely to experience fainting episodes compared to younger adults. Syncope, another word for fainting, occurs when the blood flow to a person’s brain is reduced or stopped.
According to the National 911 Office, you should call 911 if an elder who has lost consciousness. Seek immediate medical attention, particularly if the senior has heart problems, is prone to fainting episodes, or if they have lost consciousness and fallen down as a result of fainting.
There are also a few things you can do on your own to help ensure the safety of a senior who has passed out:
- Keep them from falling: Whenever possible, try and keep a senior who is fainting from falling. If your loved one says they’re feeling faint, protect their head and attempt to maneuver them as best you can towards a couch or chair.
- Get them in the right position: According to the Mayo Clinic, someone who has fainted and is still breathing should be placed on their back, with their feet situated about one foot above their heart level whenever possible. This will serve to reestablish and facilitate blood flow to your loved one’s brain. If your loved one is seated, and you can’t safely move them, try to place their head in between their knees so that it’s easier for their heart to pump blood to their brain.
- Inspect airway, possibly begin CPR: Ensure that the senior’s airway is clear of vomit and excessive saliva. If they have stopped breathing, someone who knows how to safely administer CPR, should do so.
- Give them some air: If a senior is safely positioned and breathing, crack a window, open a door, or turn on a fan to help ventilate the room. Also, untie or loosen clothing that is in any way constricting. This will help keep blood flowing throughout you loved one’s body.
- Keep an eye on the clock: Fainting spells that last for more than a minute or two are unusual, and can be a sign of a more serious medical problem. You should definitely contact emergency services if a senior remains unconscious for longer than a few minutes.
- Help them get up slowly: When a loved one comes to, don’t let them get up right away. When they do feel well enough to sit up, encourage them to do so slowly, and be sure to provide physical support, in case they feel faint again. Don’t let someone who has fainted try to walk until they have been conscious for at least fifteen minutes.
- Encourage fluids: A fully conscious senior should be encouraged to drink fluids. Plain water is fine, but, when people faint, their blood sugar generally drops, so if you can give the senior a beverage that contains sugar, it might help regulate their blood sugar. Encourage your loved one to take tiny sips to help prevent them from choking.
Fainting can be caused be a variety of things; from certain prescription medications, to standing up too fast. If your loved one is experiencing fainting episodes, it could be a sign of a more serious medical issue. Talk with their doctor about possible causes and remedies for the situation.
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Understanding Vasovagal Syncope
Vasovagal syncope is fainting caused by a complex nerve and blood vessel reaction in the body. It’s the result of an abnormal reflex in the body and is often called reflex syncope. It’s the most common cause of fainting. Unlike other causes of fainting, it’s not a sign of a problem with the heart or brain
How to say it
VAY-zo-VAY-gull
SINK-o-pee
How vasovagal syncope happens
Many nerves connect with your heart and blood vessels. These nerves help control the speed and force of your heartbeat. They also regulate blood pressure. They control whether your blood vessels should be more open or more closed.
Usually these nerves work together so you always get enough blood to your brain. In certain cases, these nerves may give a wrong signal or be slow to respond to input received from the body. This may cause your blood vessels to open wide or cause them not to get more narrow when they need to. At the same time, your heartbeat may slow down. Blood can start to pool in your legs, and not enough of it may reach the brain. If that happens, you may briefly lose consciousness. When you lie down or fall down, blood flow to the brain resumes.
What causes vasovagal syncope?
Many triggers can cause vasovagal syncope, such as:
Standing for long periods
Too much heat
Intense emotion, such as fear
Intense pain
The sight of blood or a needle
Exercising for a long time
Older adults may have additional triggers, such as:
Urinating
Swallowing
Coughing
Having a bowel movement
Symptoms of vasovagal syncope
Fainting is the main symptom of vasovagal syncope. You may have symptoms before fainting such as:
Nausea
Warm, flushed feeling
Face that turns pale
Sweaty palms
Feeling dizzy
Blurred vision
If you lie down and elevate your legs at the first sign of these symptoms, you will often be able to prevent fainting. Not everyone notices symptoms before fainting, however.
When a person does faint, lying down restores blood flow to the brain. Consciousness should return fairly quickly. You might not feel normal for a little while after you faint. You might feel depressed or fatigued for a short time. You may even feel nauseous afterwards and vomit.
Some people have only 1 or 2 episodes of vasovagal syncope in their life. For others, it happens more often and with no warning.
Diagnosing vasovagal syncope
Your healthcare provider will ask about your health history and your symptoms. He or she will give you a physical exam. Your blood pressure may be measured while lying down, seated, and standing. You may also have an electrocardiogram (ECG). This is a simple test that looks at the heart’s rhythm.
You may be checked for other possible causes of fainting. You may have other tests such as:
Continuous portable ECG monitoring, to look at heart rhythms over time, such as with a Holter or event monitor
Echocardiogram, to look at the blood flow in the heart and the heart’s motion
Exercise stress testing, to see how your heart does during exercise
Blood tests to check for signs of disease
If these tests are normal, you may have a tilt table test. For this test, you lie down on a platform with straps around you to keep you from sustaining an injury. Your heart rate and blood pressure are measured while you are lying down. The platform is then tilted upright. Your heart rate and blood pressure are measured again. If you have vasovagal syncope, you may faint during the upward tilt. Sometimes medicines that increase heart rate and the force of heart contractions or decrease blood pressure are used to try and provoke a syncopal episode.
There are many causes of syncope. Some causes are not dangerous. In older persons, unexplained syncope can be a sign of a serious infection or a heart attack. Call 911 or seek medical attention right away to be evaluated, especially if there has been a fall and injury with the syncope. You should not drive yourself to the hospital or emergency department after a syncopal episode for the safety of yourself or other drivers and passengers. Have someone drive you. Your provider may restrict your driving until the cause of the syncope is better understood and to make sure the syncope does not become chronic or if it is unpredictable.
Loss of consciousness
Loss of consciousness, especially in the elderly, can be a symptom of a serious illness.
For a short-term loss of consciousness, usually lasting from several seconds to several minutes, complete or partial absence of reaction to external stimuli is characteristic. It is accompanied by pallor, slow heartbeat, cold sweat, weakness in the legs.
The most common cause of short-term loss of consciousness or fainting is a drop in blood pressure – the heart slows down, the brain does not receive enough blood and it “turns off” for a moment.Such fainting often occurs in young or very emotional people, more often in women, it can be caused by fear, for example, the sight of blood, intense emotion, pain. The cause is mainly over-activity of the parasympathetic nervous system. It is this part of the autonomic nervous system that prepares the body for rest and rest by slowing down heart rate and breathing, narrowing the respiratory tract, and reducing muscle tension.
There are so-called orthostatic faints that occur when there is a sharp change in posture, for example, jumping out of bed, when the body cannot adapt so quickly and a sufficient amount of blood does not flow to the brain.In a moment, the body itself copes with the problem, and consciousness returns.
However, the cause of its loss may be anemia or fluctuations in blood sugar levels.
If, at the same time as short-term loss of consciousness, there are heart rhythm disturbances (not only slow heartbeat), pain in the heart, headache, dizziness, numbness or weakness in any part of the body, asymmetry of the face or pupils, convulsions, or very fast and deep breathing, the cause may be cardiovascular diseases – arrhythmia (if the heart rate is less than 30 or more than 150-180 beats per minute), myocardial infarction, angina pectoris, transient or persistent problems with cerebral circulation, such as stroke, epilepsy, or head injury.In these cases, it is best to call an ambulance, which will take the patient to the hospital.
A patient who has had one or more episodes of loss of consciousness should consult
therapist , cardiologist or neurologist .
List of symptoms 90,000 First aid for cardiovascular emergencies
Friday,
17
May
2019
Fainting is a short-term loss of consciousness. Asking the question of how to provide first aid for fainting, it is necessary to understand that such a problem is not independent, but only represents one of the signs of various disorders or malfunctions in the body. In the event that the fainting state occurred once, it can be attributed to excessive emotional stress or nervous shock. However, if a person loses consciousness quite often, there are definitely reasons for this, among which the following can be distinguished:
- Decrease in blood pressure levels, provoked by both external factors and a variety of ailments.
- Violation of full regulation of the cardiovascular system, accompanied by outflow of blood from the brain. Such a manifestation is often associated with too high physical activity or occurs due to a sharp change in body position.
- Heatstroke can occur as a result of prolonged exposure to the scorching sun, which can lead to fainting.
- Severe food and alcohol intoxication or poisoning with pharmaceuticals.
Just before fainting, most people notice prior symptoms. Therefore, in the event of the following phenomena, it is worth immediately helping the person to take a horizontal position.
• feeling of numbness in the upper and lower extremities;
Pallor of the skin;
· The appearance of ripples or “flies” in front of the eyes;
Cold sweat accompanied by freezing feet and palms;
· nausea, vomiting;
Ringing, noise, or a feeling of congestion in the ears;
· Severe weakness, in which legs may give way.
A distinctive feature of fainting is a rapid heartbeat, accompanied by perspiration and redness of the skin.
Providing first aid for fainting and the above-described signs of an impending fainting state involves not only a clear algorithm of actions, but also a number of certain things that are strongly discouraged.
In particular, a person who loses consciousness should not be sharply shaken and shaken, which is often attempted by incompetent assistants. It is also forbidden to move the patient and forcefully transfer him to a sitting or upright position.
First aid
- The person needs to be helped to take a lying position and to release him from the squeezing elements (loosen the belt, tie, open the collar).
- If ammonia (10% aqueous solution of ammonia) is at hand, moisten a cotton swab with it and bring it to the victim’s nose, but not closer than 4-5 cm (ammonia vapors have a powerful stimulating effect on the respiratory center
- The head is shifted slightly to the side so that the unconscious person does not choke on vomit.
- Windows need to be opened for oxygen supply. If the collapse has occurred due to overheating in the sun, the patient must be immediately moved to the shade.
- The patient’s lower limbs should be kept in an elevated position, which will provide an additional flow of oxygen to the brain.
Angina is a clinical syndrome characterized by a sensation or feeling of discomfort behind the breastbone, which occurs in ischemic heart disease as a result of coronary insufficiency due to a decrease in the lumen of the heart artery.
During an attack of angina pectoris, there is a feeling of tightness or heaviness in the sternum, pain radiates to the left side of the arm, shoulder or jaw. The person sweats a lot, he has a feeling of fear.
Attacks of angina pectoris occur against the background of physical exertion or strong emotional experience, which is stopped at rest. Here there is exertional angina. An attack can also occur at rest, that is, after sleeping in the morning or at night.This is angina at rest.
First aid for angina pectoris.
- First of all, ease your breathing by undoing the first buttons on your clothes, loosening the belt of your trousers and skirts.
- If possible, give the patient a semi-recumbent position. In this position, the heart’s need for oxygen decreases and the attack passes quickly.
- Immediately place nitroglycerin under the tongue for immediate relief.
- If there are no medications, to relieve a painful attack, you can put mustard plasters on the area of the heart or chest (where pain is felt).
- A hot mustard hand bath is also suitable. Take one tablespoon of dry mustard and dissolve in one liter of hot water. It will be enough to hold your hands in it for 5-7 minutes. Or immerse your hands in clean hot water for the same time.
- Explain the technique of correct breathing to the patient: it is better to breathe through the nose, slowly and deeply, holding at the height of inspiration and simultaneously maximizing the protrusion of the upper abdomen. With this breathing, the air pressure in the chest decreases, which facilitates the flow of venous blood to the heart.Slow breathing allows the body to accumulate carbon dioxide, which leads to vasodilation of the heart, which improves the supply of oxygen to the heart muscle.
Myocardial infarction is one of the clinical forms of ischemic heart disease (IHD), occurring with the development of ischemic necrosis (local tissue death) of the myocardium (the muscular middle layer of the heart, which makes up the bulk of its mass), due to the absolute or relative insufficiency of its blood supply.
The signs of myocardial infarction are as follows:
- Very severe constricting pain in the chest. It is not removed by taking nitroglycerin. It can radiate (give) to the left half of the chest, left arm or shoulder blade. Duration – from 20-30 minutes to several hours.
- Cold sweat.
- Shortness of breath.
- Rapid and irregular pulse.
- The man turns pale, complains of fear of imminent death, lack of air.
- The patient is agitated.
- Nausea, sometimes vomiting.
First aid:
- Provide the patient with complete rest and fresh air.
- Give nitroglycerin, warn that it must be completely absorbed. Give the next tablet in 5 minutes. Repeat no more than 3 times. If nitroglycerin is not available, give validol. You need to measure your blood pressure, because it can drop sharply. If this happens, nitroglycerin and validol should not be given.
- Be sure to call an ambulance.
- To calm the patient down, put 30-40 drops of valocordin or corvalol on a piece of sugar and let dissolve.
- Give 1 aspirin tablet (to reduce blood clots). The tablet should be chewed and washed down with water. You can give 2 tablets of analgin to relieve pain.
- Put mustard plasters on the calf muscles as a distraction.
- If clinical death develops, proceed to chest compressions.
90 026 90 000 Causes and treatment of fainting in the MC For the whole family Irkutsk
Fainting is considered a short-term loss of consciousness of a sudden nature. It must be remembered that this condition occurs due to an inadequate supply of oxygen and other nutrients to the brain tissue. This is usually due to a temporary decrease in blood flow.
Causes of fainting
The occurrence of fainting is associated with the inability to compensate for low blood pressure.For example, a violation of the rhythm of the heart is accompanied by a reduced release of blood. As a result, blood pressure remains low. At the same time, there is a normal state of health at rest and the appearance of weakness during physical activity. This is due to a sudden increase in the body’s need for oxygen. It is about fainting of tension. In most cases, the cause of its appearance is considered to be the load. In addition, syncope can develop if nerve impulses influence compensatory mechanisms.For example, abdominal pain is accompanied by the supply of impulses to the heart through the vagus nerve. This leads to a slowdown in the heart rate. The result is vasovagal syncope. Sometimes the appearance of fainting is associated with a decrease in the number of red blood cells and blood glucose levels. In addition, a mild stroke can lead to fainting. This is typical for the elderly.
Clinical presentation
As a rule, fainting occurs after the onset of dizziness.After a person falls, an increase in blood pressure occurs. This is due to the horizontal position of the body. Occasionally, lifting the person up too quickly will cause the victim to faint again. In some cases, palpitations precede fainting.
The onset of orthostatic syncope is associated with a sharp change in body position. A type of such fainting is considered to be the fainting of the parade. fainting is caused by prolonged exposure to the sun.
Before the onset of vasovagal syncope, nausea, blurred vision, weakness and increased sweating appear.There is a sudden blanching and slowing of the pulse. If the development of fainting is gradual, then, most likely, its cause was a decrease in glucose content, etc.
In addition, the development of hysterical fainting is possible. It is not considered to be the true form of this disease.
Diagnosis of fainting
First of all, the definition of the disease due to which fainting has developed is provided. It is recommended to clarify the following data:
1. The patient’s age.
2. Time of the first fainting spell.
3. Circumstances of fainting.
4. Antecedent symptoms.
5. A set of measures that helps to normalize the state.
To identify causes of fainting use electrocardiography, echocardiography, blood tests, etc. To diagnose epilepsy, the symptoms of which are similar to fainting, electroencephalography is used.
Treatment of fainting
As a rule, lifting the legs of a person is sufficient to normalize the condition.This helps to speed up the recovery of consciousness and increase blood flow to important organs such as the brain and heart. The cause of fainting affects the fight against fainting. Reducing heart rate in the elderly involves the introduction of a pacemaker. We are talking about an electronic device with the help of which a disturbed heart rhythm is restored. A defibrillator is used to correct some types of abnormal heart rhythms. Heart valve pathology is an indication for surgical intervention (valve replacement).
90,000 Heat exhaustion and heatstroke – hot weather risks
Hot weather is a source of increased danger for children and people with poor health. In combination with high humidity, the risks increase. The main rules are to avoid being outdoors for a long time, be sure to wear a hat, and limit physical activity in the open air during the peak of the heat. Given that thirst is not a necessary sign of dehydration, a person may not notice overheating.To make it easier for the child to endure the heat, you can wipe the child with a damp towel and give him more to drink. Keep in mind that children overheat 3-5 times faster than adults, so even in frosty weather, a dressed baby who is left in a car with a heater and in the sun can be seriously injured.
Disturbances caused by exposure to high temperatures develop as a result of a combination of increased heat input and reduced heat transfer.
Impaired body cooling can be attributed to obesity, high humidity, high ambient temperatures, warm clothing, or any other factor that impairs perspiration or perspiration evaporation.
The elderly and young children are at high risk. The risk is higher in older people because they are more likely to take drugs that increase the risk, they are more likely to develop dehydration and heart failure. In children, the increased risk is associated with a higher body surface area-to-weight ratio (which creates conditions for more heat consumption from the environment on hot days) and a lower rate of sweat production. Children acclimatize more slowly and feel less thirsty.Both the elderly and young children can be relatively sedentary, which prevents them from leaving the place of exposure to high temperatures on their own.
In very hot weather, children and the elderly should not stay in unventilated areas unless air conditioning is provided.
Adults should never leave children in the car in summer! When the outside air temperature is 27C in the car, it is 10 degrees higher, even if the windows are open.A critical condition – heatstroke, comes on very quickly, and is one of the reasons for the death of children. Even if the child manages to provide qualified assistance on time, the consequences of heatstroke can be irreversible. At a temperature of 42 C, convulsions, loss of consciousness, vomiting occur, and cerebral edema may occur.
If you are traveling with a child in stuffy transport, you can put a thin scarf soaked in cool water around his neck, or just a piece of cloth. The water can even be warm – the main thing is that it will cool the location of the large vessels.When you come home, rinse your hands and neck with cold water.
Also try to adhere to the following rules:
do not let children get into the car to play;
do not leave doors open;
when driving, check that the car seat does not overheat;
in summer, use light-colored child seat covers that absorb sweat better and attract less heat.
Heat exhaustion is a non-life-threatening clinical syndrome with weakness, malaise, nausea, fainting, and other non-specific symptoms caused by heat exhaustion. Thermoregulation and central nervous system functions are not impaired, however, as a rule, dehydration occurs and a moderate increase in body temperature is possible. Treatment: rest in a cool place and replace fluid loss.
Heat exhaustion differs from heatstroke in the absence of abnormalities in the brain (eg, confusion, ataxia).
Symptoms are often nonspecific and patients may not be aware that overheating is the cause. General discomfort, weakness, dizziness, headache, nausea, and sometimes vomiting are possible. Fainting associated with prolonged exposure to heat (heat fainting) may occur. On examination, the patient looks tired, usually he has increased sweating and tachycardia, orthostatic hypotension is possible. The mental state is not affected, unlike in cases of heatstroke.The temperature is normal, and when it rises, it usually does not exceed 40 ° C.
The diagnosis of heat exhaustion is made on the basis of clinical data, additional tests are performed according to indications to exclude other conditions similar in clinical presentation.
( Remember: even a slight alcoholic intoxication in combination with the scorching sun can lead to overheating, and a very drunk person will not feel that the body is “boiling” at all! If a person is in open water, he may lose consciousness and drown.This will happen unnoticed by others, and you may not have time to provide first aid )
Heatstroke is a hyperthermia accompanied by a systemic inflammatory response that causes multiple organ failure and is often fatal. Symptoms include fever> 40 ° C and impaired mental health; sweating may be absent. The diagnosis can only be made by a medical professional. However, there are certain symptoms to watch out for.It is imperative to act quickly and call 112 or 103 first.
Classic heatstroke develops within 2–3 days of exposure to high temperatures. It occurs more often in summer, in hot weather, usually in elderly sedentary people living in rooms without air conditioning, often with limited access to fluids. Heatstroke can quickly develop in children left in a stuffy car, especially with closed windows.
The main signs are CNS dysfunction, ranging from confusion and strange behavior to delirium, seizures, and coma.Ataxia can be an early symptom. Tachycardia, even when lying on the back, and tachypnea are common. Sweating may or may not be present. The temperature rises> 40 ° C.
Heatstroke differs from heat exhaustion by the exhaustion of compensatory mechanisms of heat transfer, the presence of dysfunction of the central nervous system, and an increase in temperature> 40 ° C.
In the event of heatstroke, an ambulance should be called immediately, as this is a life-threatening condition.Move the victim to a cool place, turn on the fan, put compresses with ice on the palms, feet, cheeks, spray lukewarm water on the body. Attempts to cool the person should be continued until the ambulance arrives. You cannot use any drugs if you are not qualified as a health care provider.
To avoid overheating, replenish fluid loss by the body in time, it is better to use clean water for this. Sugary drinks will only increase your thirst. There is a common misconception that it can be quenched with beer.However, the alcohol contained in it will only contribute to the dehydration of the body, and hot weather will increase the load on the excretory system, which is already working in full force. The liquid must be drunk, regardless of the feeling of thirst, every few hours. The maximum net water absorption in the intestine is about 20 ml / min (1200 ml / h, which is lower than the maximum sweating rate of 2000 ml / h).
Heatstroke must be distinguished from sunstroke and also from poisoning (especially in young children).If you are not a specialist, it will be difficult for you to correctly identify the painful condition. Therefore, the sooner you seek medical attention, the more effective the treatment will be.
Anemia in the elderly | The health of our parents
At least 40% of people over 60 suffer from anemia, a disease in which the human body experiences a deficiency of red blood cells and hemoglobin in the blood, which is why the blood does not receive enough oxygen.Despite the fact that anemia is so common among older people, this disease is not at all an inevitable phenomenon associated solely with age. Practice shows that in most cases it is possible to establish the cause of anemia, and the disease itself can be cured in a timely manner.
The most common symptoms of anemia are: weakness, dizziness, lethargy, confusion, fainting, skin and mucous membranes with anemia become pale. The development of anemia leads to a significant deterioration in the quality of life of the elderly, rapid fatigue, and depressed mood., decrease in physical and mental activity. With anemia, a person’s cognitive functions are significantly reduced, memory is reduced and concentration of attention is lost.
People often mistake the symptoms of anemia listed above for manifestations of a general deterioration in health or ascribe it to exacerbated chronic diseases. Meanwhile, when these symptoms appear, it is necessary to take a blood test in order to timely diagnose or refute the presence of anemia in an elderly person.In accordance with the obtained indicators of hemoglobin, the doctor can diagnose the degree of anemia, and according to the characteristics of erythrocytes, determine its type.
The following causes of the onset and development of anemia in old age are distinguished:
- Anemia due to chronic diseases. Usually, in old age, people have several chronic diseases at once. This type of anemia is usually not severely severe. Treating this type of anemia undoubtedly means treating one or more of the diseases that cause it.In this case, taking medications to increase the level of iron in the body alone will be ineffective.
- Iron deficiency anemia, when a significant iron deficiency occurs in the body due to an unbalanced diet or due to bleeding in the gastrointestinal tract. The cause of such bleeding can be gastric ulcer and duodenal ulcer, ulcerative colitis, intestinal diverticulitis, various tumors in the gastrointestinal tract.
- Vitamin B12 deficiency anemia.This type of anemia is difficult to diagnose, because the main symptoms: weakness and dizziness are characteristic of a very wide range of different diseases. Usually, this type of anemia is also associated with an existing chronic disease of the gastrointestinal tract. Only regular blood tests in an elderly person make it much easier to detect a lack of vitamin B12 in the body.
- Anemia due to folic acid deficiency. The entry of folic acid into the body occurs directly with food intake.Therefore, poor-quality and unbalanced nutrition leads to a lack of this acid, which is necessary for normal human life.
Each type of anemia has its own set of treatment measures. In addition, when treating anemia in old age, it is necessary to take into account the concomitant diseases that a person has, so as not to lead to their complication.
The correct diet is of particular importance both for the prevention of anemia and for its treatment. In the diet of an elderly person suffering from anemia, there should be a sufficient amount of animal proteins (veal, beef, liver, offal), which contribute to the synthesis of hemoglobin and red blood cells.For the prevention and treatment of anemia, you should also consume iron-rich fruits and vegetables: apples, pomegranates, persimmons, dates, prunes, spinach, parsley, cauliflower and others.
90,000 Loss of consciousness. Why Fainting Happens And When To See A Doctor | Healthy life | Health
A word to our expert, neurologist, author of books on a healthy lifestyle, Doctor of Medical Sciences, Professor Evgeny Shirokov .
False alarm
As a rule, benign (not associated with serious causes) syncope is caused by a short-term cessation of oxygen supply to the brain.Such situations often provoke:
Prolonged stay in a lying or standing position, in a forced position
Such fainting is called positional. It often occurs in people who have been on bed rest for a long time, were in a standing, motionless position in transport, as well as when suddenly getting up from a chair, out of bed. At risk are patients with varicose veins, pregnant women, as well as elderly people suffering from atherosclerosis, whose vessels that have lost their elasticity are not able to quickly respond to changes in body position.
Should you worry? As a rule, positional syncope does not pose a threat to health and is rather of a protective nature, when, in response to a sudden outflow of blood to the lower extremities and the resulting oxygen deprivation, our brain, like a computer, switches to a maintenance mode.
What to do? Try to avoid situations that provoke a sudden loss of consciousness: do not stand for a long time, do not get up abruptly. This is especially true for the elderly.
Arterial hypotension
We are talking about those who from birth live with low blood pressure (below 100/60 mm Hg. Art.). Fainting for such people, most of whom are young women in their 20s and 40s, is a piece of cake.
The tendency to fainting is also increased in people suffering from vegetative-vascular dystonia, in whom the regulatory vascular mechanisms are impaired. The impetus for a sudden loss of consciousness in such people can be a strong psychological, painful stress, a sharp change in body position.
Should you worry? Not worth it. Such fainting goes away immediately after the unconscious person takes a horizontal position.
What to do? The most effective prevention of repeated fainting in hypotension and vegetative-vascular dystonia is vascular tone training using a contrast shower, massage, isometric exercises, which include a wrist expander.
Osteochondrosis of the cervical spine
In which venous outflow and blood supply to the brain may be impaired.Sudden fainting in such people can lead to sharp turns of the head (to the side, back).
Should you worry? Osteochondrosis does not die, but it makes life very difficult, exhausting its owner with a headache or pain in the shoulder, forearm, numbness, burning sensation, tingling in the arms or legs, and sometimes pressing pains in the heart, radiating to the shoulder blade, forearm.
What to do? To make an X-ray of the cervical spine, and, if necessary, magnetic resonance imaging, USDG of cerebral vessels and some other studies.
Reason to be wary
Sudden impairment of consciousness can also occur in dangerous conditions, which include:
Cardiac arrhythmias
Normal heart rate is 60–90 beats per minute. With arrhythmias (violation of the frequency, rhythm and sequence of excitation and contractions of the heart), it increases or decreases, the heart works intermittently, irregularly.
Should you worry? Worth, because heart rhythm disturbance can lead to atrial fibrillation and cardiac arrest, as well as cardioembolic stroke.
What to do? Undergo an examination that, in addition to the usual electrocardiogram, includes a daily ECG record (so-called Holter monitoring), an exercise test (on a bicycle ergometer or a treadmill), and an ultrasound examination of the heart.
Pulmonary embolism
A life-threatening condition characterized by blockage of the pulmonary artery by a blood clot that has come off the walls of the vessels of the lower extremities. At risk are representatives of sedentary or standing professions, passengers on long flights, people who have undergone a serious operation and have been on bed rest for a long time.The situation is aggravated by the use of hormonal contraceptives and a number of other drugs that shift the blood formula towards thickening.
Should you worry? Pulmonary embolism is a emergency situation requiring urgent resuscitation measures.
What to do? Do not bring to trouble and if there is bursting pain in the leg, its edema, undergo Doppler ultrasound of the lower extremities, if necessary, take coagulants (drugs that thin the blood), as well as wear compression underwear.
Can also cause sudden fainting
- Traumatic brain injury
- Anemia
- Taking certain medications (nitrates, antidepressants, etc.)
- Poisoning (carbon monoxide, alcohol, etc.)
- Epilepsy
- Decreased blood sugar (hypoglycemia)
- Renal, liver failure
- Neuroinfection (meningitis)
- Bleeding (gastrointestinal, uterine, etc.)etc.)
First aid for fainting
- Place the patient with their legs raised above the level of the body and head.
- Free him from the tight clothing.
- Bring ammonia to your nose.
- Do not try to lift the patient up and put him on his feet.
- Do not give nitroglycerin or other drugs to the victim.
Fundamental Guide to Know
Our brain uses various structures to work with existing types of memory.There are two main types of memory: short-term memory and long-term memory. Although dysfunctions of both types of memory are possible, we will focus on Long-Term Declarative Memory.
- Short-term memory retains a limited amount of information for a short period of time.
- Non-volatile memory stores a large amount of complex information for a long time. This is what is commonly referred to as “memory”.In turn, there are two types of Long-Term Memory: Non-Declarative or Implicit Memory (cycling, driving) and Declarative or Explicit Memory, used to recall our personal experience or knowledge about the world around us (what is the name of my relative, where I left clues to who runs my country, which happened five minutes or five months ago).
What is memory loss and symptoms
If we forget something, as a rule, we do not “lose” the memory by itself, but our brain “cannot find a way” to what we are trying to remember.This “pathological” memory loss is called amnesia. Here are some symptoms of memory loss:
- Losing personal belongings often.
- Difficult to find the right words.
- Asking repetitive questions during conversation, or telling the same story multiple times.
- Forgetting whether you did something or not, such as taking medication.
- Get disoriented or lost in familiar places.
- Confuse the year or day of the week.
- Forget about appointments or events.
- Have difficulty making decisions or following instructions.
Types of memory loss: Transient and Permanent
Memory loss can manifest itself in two forms: temporary (transient) and permanent (permanent) memory loss.
- Transient or temporary memory loss is a temporary forgetting of information, which after a while is restored in our memory.If we cannot remember a name but then remember it an hour later, or if we wake up in the morning and cannot remember what happened the night before after drinking alcohol, this is considered temporary memory loss.
- Permanent or permanent memory loss is information that we lose and cannot recover. If we are unable to remember, even if we are reminded of this by another person where they left the keys to the house, or if we forget about the meeting with our brother scheduled the night before, we are dealing with permanent memory loss.
Causes of memory loss: medical, emotional and age-related problems
There are several factors that can lead to involuntary memory loss in both young and old age. Many of these factors are not due to poor memory performance, but due to interference from other cognitive abilities (such as attention) or certain substances (such as drugs).
- Memory loss due to health problems which, in most cases, are treatable: side effects of certain medications, unbalanced diet with low levels of vitamins B6, B9 and B12 can lead to temporary memory loss, alcohol abuse, thyroid disease , kidney or liver, lack of oxygen in the brain (such as with a stroke), sequelae of traumatic brain injury (head injury), cancer treatment (chemotherapy or radiation therapy), brain tumors or infections, emotional problems (such as depression), and anxiety (such as , post-traumatic stress).
- Memory loss due to stress, anxiety and other emotional problems : In addition, stress, anxiety and some of the consequences of strong emotions such as anger can lead to forgetfulness. If we are involved in a car accident, stress can make us lose our memories of what happened this morning. But, as a rule, these memory losses occur because we focus on threatening stimuli and remove less meaning from our surroundings.Thus, we can remember what caused these strong emotions in us, but we cannot recall all the events that happened during this time in our memory. This occurs in the case of PTSD and Obsessive-Compulsive Disorder. In these disorders, the person focuses so much on an emotional episode or object of possession that they ultimately remember nothing except for that stimulus.
- Memory Loss with Age and Normal Aging : While forgetfulness and memory disorders do not occur exclusively in older people, it is true that these people are more susceptible to such problems.With age, the ability to learn and the quality of memory can deteriorate even without the presence of any pathology. However, when these problems become more severe than usual, we may speak of mild cognitive impairment or, in more severe impairments, dementia.
- Memory loss due to emotional problems in older people: It is common for older people to feel lonely when they lose loved ones, or not feel useful when they retire. Given these changes, it is normal that some of the older people suffer from emotional distress, such as depression.Depressed seniors may be more likely to experience feelings of memory loss and confuse these symptoms with Alzheimer’s or other memory problems. Depression can cause serious memory problems in both the elderly and young people, but in the case of elderly patients it is very important to have an appropriate differential diagnosis to rule out the presence of Alzheimer’s disease. Although memory problems in people with depression may not be as relevant as in other pathologies, it is necessary to pay attention to the emotional problems they suffer from.
- Mild Cognitive Impairment Memory Loss: Mild Cognitive Impairment is a disorder that results in memory loss, but does not interfere with the person suffering from it in their daily activities. Some studies indicate that mild cognitive impairment may be an early sign of Alzheimer’s disease, although not in all cases these impairments lead to Alzheimer’s disease.
- Memory loss due to dementia is one of the most important health problems in older people, but it is not a normal consequence of aging.Dementia usually includes the onset of chronic cognitive problems such as problems with memory, speech, behavior, etc. There are different types of dementia, but the most common form is Alzheimer’s.
- Memory Loss Caused by Alzheimer’s In this disease, a protein called amyloid beta builds up in neurons, forming senile plaques, until these neurons lose their vitality. This leads to gradual and severe memory impairment, problems with orientation (patients often do not know what day it is and where they are), difficulties in calculations and, in general, with the implementation of everyday tasks.The severity of the disease varies depending on the stage the patient is in. In the mild stage, a person with Alzheimer’s may show significant memory loss, get lost in a familiar place, withdraw from everyday activities and conversations, may forget dates, and show symptoms of depression and hostility. In the moderate stage, cases of memory loss are most striking, people may forget names or things that happened a few minutes ago, have difficulty shopping or preparing food, may neglect personal hygiene, have speech problems or are aggressive, tend to forget their way, and ultimately, their daily life becomes impossible without help.In an advanced stage, patients may have problems with eating or understanding simple information, they do not recognize relatives and friends, and behave inappropriately in public. At this stage, the person becomes completely dependent.
Preventing memory loss
How to prevent memory loss? Factors that have been shown to be most effective in preventing or slowing down Alzheimer’s and other memory problems: healthy sleep , good nutrition , exercise , active social life and cognitive performance .Our brain functions like muscles: the more actively we use it, the better its condition will be. Conversely, if our brains are not getting enough nutrition and oxygen through exercise, and if we do not use our social and cognitive abilities, we will tend to atrophy. For this reason, an active and healthy lifestyle can be very beneficial for our memory. CogniFit offers a wide range of scientifically proven exercises to keep your brain active and to train your cognitive abilities.In addition, cognitive performance not only enhances memory in adults and the elderly, but can also contribute to the development of intellectual abilities in children and young people.
Cognitive Stimulation stimulates, trains and strengthens various cognitive abilities such as attention, perception, memory, speech and executive functions. These are the very abilities that can be impaired in dementia and other diseases associated with memory loss.By doing exercises that involve different cognitive abilities, we help the brain strengthen neural connections, preventing damage to it. However, cognitive stimulation cannot be haphazard; it needs reliable techniques and detailed organization, in accordance with the needs of each patient. CogniFit focuses on personalizing your exercise program to maximize your workout performance and effectively prevent cognitive problems.
In addition, proper sleep patterns and frequent reading help keep memory in good health. Of course, it is necessary to give up bad habits associated with the use of alcohol, tobacco or other drugs – this will help strengthen both memory and health in general.
When should you seek help? Detecting and assessing memory problems
It is common for people with memory problems to be unaware of their existence, so these problems are usually first discovered by their relatives.
On the other hand, people prone to anxiety and depression can become obsessed with their mistakes. They often overestimate their forgetfulness, thinking that they have memory problems, but this is not always the case. If we sometimes suddenly forget the name of an object or the name of a person with whom we usually communicate a lot, or forget why we went to the room or where we left our keys, or forget to take lunch to work, this is not a cause for concern.
However, if the person has problems performing daily tasks, or if they seem confused and disoriented, it is time to see a doctor.It is recommended to write down all information about the course of violations: when memory problems began, what deterioration was observed, what type of information is forgotten, how it affects everyday, social and work life. The attending physician must make an accurate diagnosis and determine if the patient has memory problems, and if so, what kind of these problems. In case of doubt, it is always best to consult a specialist.
However, brief episodes of memory loss do not mean that we are talking about serious memory problems, let alone Alzheimer’s disease.We all forget something from time to time, and this is normal (slight memory loss). Our brain has to forget something in order to correctly process new information.
How to treat or reduce memory loss?
Treatment of dementia should be carried out from a multidisciplinary point of view. Depending on the type disease, the phase the patient is in, and the specific characteristics of the patient, the participation of a neurologist, psychiatrist, family doctor, therapist, geriatrician, psychologist, neuropsychologist, speech therapist, physiotherapist, occupational therapist and junior medical personnel.
In the case of Alzheimer’s disease, the treating physician must develop an appropriate diagnosis and treatment. In addition, the treatment program can include exercises to stimulate cognitively the brains of patients with early Alzheimer’s disease. In more advanced stages, other treatments, including medication, are usually used. While Alzheimer’s is currently considered incurable, these drugs are aimed at maintaining the patient’s impaired abilities and addressing associated behavioral problems.
In addition, taking preventive measures can help slow the progression of dementia once it is diagnosed. Combining medication with proper diet, exercise, social life, and cognitive stimulation helps to minimize the effects of dementia on a patient’s daily life.
What if a family member has memory loss?
In case of detection of undiagnosed memory problems with your friend, you should recommend him to contact a specialist .It is normal to receive refusals from offered help, as many patients are not aware of their problems. Therefore, you should approach this issue with patience and with caution .
After the attending physician has made a diagnosis, it is necessary to follow its prescriptions. If this is a mild disease, we need to help this person carry out the daily tasks both at home and socially. One of the main problems with Alzheimer’s is temporary disorientation, so it is important to place clocks and calendars in the patient’s field of vision.Despite the fact that the illness interferes with the learning process, it is strongly recommended to train the patient to use the diary and not to reduce the usual volume of tasks. Close people should help him follow the doctor’s recommendations, take the pills correctly and perform the actions related to the treatment. It can be very difficult for a patient to accept their diagnosis. Therefore, emotional support of loved ones is very important for him, so that the situation is not perceived so painfully. If symptoms of depression are found, it is necessary to inform a doctor or psychologist as soon as possible.
- Forgetfulness does not mean memory problems.
- You must be able to distinguish between the signs of Mild Cognitive Disorder and dementia, such as Alzheimer’s, so that you can spot them as soon as possible and seek professional help. However, not all memory problems are associated with these disorders, however, they also require medical attention.