Syncope is associated with multidimensional frailty in older adults

Abstract Background Multidimensional frailty and syncope are common in older adults, yet their relationship remains unclear. Methods This retrospective multicenter study, involving outpatients who underwent Comprehensive Geriatric Assessment, aims to evaluate the relationship between frailty and syn...

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Main Authors: Francesco Curcio, Rosaria Chiappetti, Pietro Medio, Sara Pacilio, Gennaro Alessio, Federica Trotta, Ciro Abete, Ilaria Liguori, Gaetano Gargiulo, Giuseppe Sasso, Francesco Cacciatore, Gianluigi Galizia, Pasquale Abete, GIMSI (Italian Multidisciplinary Group for the Study of Syncope)
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06280-2
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author Francesco Curcio
Rosaria Chiappetti
Pietro Medio
Sara Pacilio
Gennaro Alessio
Federica Trotta
Ciro Abete
Ilaria Liguori
Gaetano Gargiulo
Giuseppe Sasso
Francesco Cacciatore
Gianluigi Galizia
Pasquale Abete
GIMSI (Italian Multidisciplinary Group for the Study of Syncope)
author_facet Francesco Curcio
Rosaria Chiappetti
Pietro Medio
Sara Pacilio
Gennaro Alessio
Federica Trotta
Ciro Abete
Ilaria Liguori
Gaetano Gargiulo
Giuseppe Sasso
Francesco Cacciatore
Gianluigi Galizia
Pasquale Abete
GIMSI (Italian Multidisciplinary Group for the Study of Syncope)
author_sort Francesco Curcio
collection DOAJ
description Abstract Background Multidimensional frailty and syncope are common in older adults, yet their relationship remains unclear. Methods This retrospective multicenter study, involving outpatients who underwent Comprehensive Geriatric Assessment, aims to evaluate the relationship between frailty and syncope. Patients were classified as fit/light frail, moderate frail or severe frail based on their fr-AGILE score. Patients reporting one or more episodes of syncope were referred to “Syncope and Fall Unit” and evaluated according to the recommendations of the European Society of Cardiology. Syncope episodes were classified in cardiac, reflex, orthostatic and of unknown origin. Multiple logistic regression analysis was employed to determine the association between the frailty score and syncope, independent of age, sex, comorbidity, and polypharmacy. Results Among 560 patients (mean age 77.7 ± 6.9 years, 54.5% female), 107 reported experiencing syncopal episodes. Patients with history of syncope had a higher prevalence of orthostatic hypotension (41.1% vs. 18.8%, p = 0.001) and a higher fr-AGILE score (6.5 ± 2.0 vs. 5.4 ± 1.9, p = 0.001). Multivariate logistic regression analysis, adjusted for age, sex, comorbidity, and number of medications, showed that frailty, estimated by the fr-AGILE score, was associated with an increased risk of syncope (OR for each unit increase in fr-AGILE: 1.468, 95% CI: 1.276–1.690, p = 0.001). Frailty was associated with syncope, particularly cases of undetermined origin, but not with cardiac syncope. Conclusions The fr-AGILE score identifies patients at high risk of syncope. Frailty is strongly associated with non-cardiac syncope and with cases where a pathophysiological cause of the syncopal event could not be determined.
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spelling doaj-art-ddf6b32306bf4086b39f661cbd5ec84f2025-08-24T11:49:22ZengBMCBMC Geriatrics1471-23182025-08-012511910.1186/s12877-025-06280-2Syncope is associated with multidimensional frailty in older adultsFrancesco Curcio0Rosaria Chiappetti1Pietro Medio2Sara Pacilio3Gennaro Alessio4Federica Trotta5Ciro Abete6Ilaria Liguori7Gaetano Gargiulo8Giuseppe Sasso9Francesco Cacciatore10Gianluigi Galizia11Pasquale Abete12GIMSI (Italian Multidisciplinary Group for the Study of Syncope)Department of Translational Medical Sciences, University of Naples Federico IIDepartment of Translational Medical Sciences, University of Naples Federico IIDepartment of Translational Medical Sciences, University of Naples Federico IIDepartment of Translational Medical Sciences, University of Naples Federico IIDepartment of Translational Medical Sciences, University of Naples Federico IIDepartment of Translational Medical Sciences, University of Naples Federico IIDepartment of Translational Medical Sciences, University of Naples Federico IIDepartment of Translational Medical Sciences, University of Naples Federico IIDivision of Internal Medicine, AOU San Giovanni Di Dio E Ruggi Di AragonaDepartment of Emergency and Critical Care, AORN A. CardarelliDepartment of Translational Medical Sciences, University of Naples Federico IIIRCCS Salvatore Maugeri Foundation, Scientific Institute of VerunoDepartment of Translational Medical Sciences, University of Naples Federico IIAbstract Background Multidimensional frailty and syncope are common in older adults, yet their relationship remains unclear. Methods This retrospective multicenter study, involving outpatients who underwent Comprehensive Geriatric Assessment, aims to evaluate the relationship between frailty and syncope. Patients were classified as fit/light frail, moderate frail or severe frail based on their fr-AGILE score. Patients reporting one or more episodes of syncope were referred to “Syncope and Fall Unit” and evaluated according to the recommendations of the European Society of Cardiology. Syncope episodes were classified in cardiac, reflex, orthostatic and of unknown origin. Multiple logistic regression analysis was employed to determine the association between the frailty score and syncope, independent of age, sex, comorbidity, and polypharmacy. Results Among 560 patients (mean age 77.7 ± 6.9 years, 54.5% female), 107 reported experiencing syncopal episodes. Patients with history of syncope had a higher prevalence of orthostatic hypotension (41.1% vs. 18.8%, p = 0.001) and a higher fr-AGILE score (6.5 ± 2.0 vs. 5.4 ± 1.9, p = 0.001). Multivariate logistic regression analysis, adjusted for age, sex, comorbidity, and number of medications, showed that frailty, estimated by the fr-AGILE score, was associated with an increased risk of syncope (OR for each unit increase in fr-AGILE: 1.468, 95% CI: 1.276–1.690, p = 0.001). Frailty was associated with syncope, particularly cases of undetermined origin, but not with cardiac syncope. Conclusions The fr-AGILE score identifies patients at high risk of syncope. Frailty is strongly associated with non-cardiac syncope and with cases where a pathophysiological cause of the syncopal event could not be determined.https://doi.org/10.1186/s12877-025-06280-2Multidimensional frailtySyncopeComprehensive Geriatric Assessment
spellingShingle Francesco Curcio
Rosaria Chiappetti
Pietro Medio
Sara Pacilio
Gennaro Alessio
Federica Trotta
Ciro Abete
Ilaria Liguori
Gaetano Gargiulo
Giuseppe Sasso
Francesco Cacciatore
Gianluigi Galizia
Pasquale Abete
GIMSI (Italian Multidisciplinary Group for the Study of Syncope)
Syncope is associated with multidimensional frailty in older adults
BMC Geriatrics
Multidimensional frailty
Syncope
Comprehensive Geriatric Assessment
title Syncope is associated with multidimensional frailty in older adults
title_full Syncope is associated with multidimensional frailty in older adults
title_fullStr Syncope is associated with multidimensional frailty in older adults
title_full_unstemmed Syncope is associated with multidimensional frailty in older adults
title_short Syncope is associated with multidimensional frailty in older adults
title_sort syncope is associated with multidimensional frailty in older adults
topic Multidimensional frailty
Syncope
Comprehensive Geriatric Assessment
url https://doi.org/10.1186/s12877-025-06280-2
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