What is a common cause of syncope in geriatric patients?

• A. Dehydration
• B. Anxiety
• C. Cardiac dysrhythmia
• D. Hypoglycemia

Answer: (C)

Syncope in older adults is most often tied to problems that abruptly reduce the heart’s output and cerebral blood flow. Cardiac dysrhythmias—whether too slow (bradyarrhythmias) or too fast (tachyarrhythmias)—directly disrupt the heart’s pumping ability, which can cause a sudden drop in brain perfusion and a loss of consciousness. As people age, underlying heart disease and conduction system changes make arrhythmias a common and important cause of fainting, sometimes with little warning. This is why cardiac rhythm disturbances are emphasized in evaluation and management.

Dehydration can lead to fainting by volume depletion and orthostatic hypotension, especially in the elderly, but it’s typically a volume-related issue rather than an abrupt cardiac event. Anxiety may cause lightheadedness but not true syncope as often. Hypoglycemia can cause loss of consciousness, especially in diabetics, but overall it’s less commonly the primary cause of syncope in geriatric patients compared with rhythm disturbances.