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Cardiovascular Disease in the Elderly: Cardiogeriatric Assessment, Prevention, Treatment Outcomes and Perspectives

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Dr. Georgia Vamvakou

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Department of Cardiology & 65+ Geriatric Outpatient Clinic, Amalia Fleming General Hospital, 14, 25th Martiou Str., 15127 Melissia, Greece
Interests: geriatric cardiology; cardiovascular rehabilitation; aging research; personalized medicine

Special Issue Information

Dear Colleagues,

This Special Issue will focus on cardiovascular disease in the elderly: cardiogeriatric assessment, prevention, treatment, outcomes, and perspectives.

The issue aims to integrate the latest insights from epidemiological data, frailty scores, preinterventional assessment, clinical characteristics of cardiovascular disease in the elderly, treatment plans, and outcomes, as well as perspectives concerning public health and the role of the digital era in addressing diagnosis and therapeutic planning.

Topics covered will include the following:

Cardiogeriatric assessment regarding frailty, fall risk scores, sarcopenia, and obesity in the elderly at the clinical level. Preinterventional assessment before cardiac surgery or other cardiovascular intervention and outcomes.
Epidemiological data on cardiovascular disease trends in the elderly population at the national or global level. Perspectives concerning public health.
Primary and secondary prevention strategies. Clinical characteristics of cardiovascular disease in the elderly. Therapeutic goals, postinterventional cardiogeriatric rehabilitation, cardiovascular rehabilitation planning, and outcomes.
The role of digital medicine in the diagnosis and treatment of the elderly and its impact on quality of life.
Submissions are expected to include original research articles and review papers that advance our understanding of the role of cardiovascular disease in the elderly.

Contributions that highlight new insights on cardiovascular disease in the elderly and present therapeutic strategies for promoting healthy aging are especially welcome.

Dr. Georgia Vamvakou
Guest Editor

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Research

15 pages, 815 KB

Open AccessArticle

Cardiac Syncope: An Underestimated Cause of Unexplained Syncope in the Elderly-Data from a Single High-Volume Syncope Unit

by Stefanos Archontakis, Evangelos Oikonomou, Nikias Milaras, Panagiotis Dourvas, Tzonatan Klogkeri, Dimitrios Kalantzis, Anastasios Markakos, Michail Ampeliotis, Artemis Papadima, Dimitrios Venetsanos, Sotirios Tsalamandris, Dimitrios Syrseloudis and Skevos Sideris

J. Clin. Med. 2026, 15(6), 2450; https://doi.org/10.3390/jcm15062450 - 23 Mar 2026

Viewed by 595

Abstract

Background/Objectives: Syncope remains a common problem in the elderly, adversely affecting quality of life, morbidity and mortality. Diagnosis is challenging due to the atypical presentation, multifactorial aetiology, overlap with non-syncoptic falls and increased prevalence of cardiac disease. This study aims to investigate the impact of cardiac syncope in this high-risk population. Methods: A retrospective single-centre observational cohort study, including 171 patients ≥65 years old with syncope of unknown origin or other falls, was conducted. Different diagnostic tests and strategies were utilised during the investigational process, based on clinical judgement and the latest guidelines. Patients were classified either in the ‘high risk’ (‘cardiac’) or ‘low-risk’ (‘autonomic’) pathway. Results: Mean age was 76.4 ± 6.6 years (range: 65–92 years old) and the mean follow-up period was 40.5 months. Our study population was characterised by a high incidence of comorbidities and underlying heart disease, and polypharmacy. One third of the patients did not report prodromals, 81.9% had no recognisable trigger and 43.3% had various 12-lead ECG abnormalities. Overall, 67.8% of the patients were stratified in the ‘cardiac pathway’. Eventually, a final diagnosis was established in 126 patients (73.7%). The cause was cardiac syncope in 56.4%, reflex syncope in 26.2%, orthostatic hypotension in 7.9% and non-syncopal falls in 9.5%. An ILR was implanted in 90.1% with a diagnostic yield of 43%. ECG-based diagnosis occurred in 53.2% whereas time to diagnosis was 4.8 ± 3.3 months. Conclusions: Cardiac disease, mostly arrythmias, represent a common and possibly underestimated cause of unexplained syncope in the elderly. A structured approach including a targeted use of ILRs improves investigational process. Full article

(This article belongs to the Special Issue Cardiovascular Disease in the Elderly: Cardiogeriatric Assessment, Prevention, Treatment Outcomes and Perspectives)

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Cardiovascular Disease in the Elderly: Cardiogeriatric Assessment, Prevention, Treatment Outcomes and Perspectives

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