Cognitive Impairment Is Very Common in Elderly Patients With Syncope and Unexplained Falls

Abstract Objectives To evaluate the prevalence of cognitive impairment (CI), including mild CI and dementia, in elderly patients with syncope and unexplained falls. In this population, we compared the use of the Mini-Mental State Examination (MMSE) with a cognitive screening test that assesses executive dysfunction typical of subcortical (vascular) CI, that is, the Montreal Cognitive Assessment (MoCA). Design Observational cohort study. Setting Outpatient fall and syncope clinic. Participants Consecutive patients aged ≥65 years with syncope and unexplained falls without loss of consciousness. Measurements Baseline characteristics, functional status, MMSE, MoCA, and magnetic resonance imaging scans of the brain. Main outcome: prevalence of CI, comparing the MMSE with the MoCA. CI was defined as an MMSE/MoCA score