Causes of blackouts in elderly people

A true blackout involves losing awareness or posture for a short time and then recovering. Standing up quickly, not drinking enough, fever, vomiting, or medicines that lower blood pressure can reduce blood flow to the brain. An abnormal heartbeat may briefly limit blood flow without warning. Diabetes medicines can contribute to low blood sugar, especially when meals are missed.

Confusion after the event, a bitten tongue, unusual movements, or loss of bladder control can point towards a seizure, although fainting can also include brief jerks. A fall may cause a head injury even when the original cause was minor. Black stools can indicate bleeding higher in the digestive tract; related conditions include Gastritis, Helicobacter Pylori Infection, and Peptic Ulcer.

Keep the person lying down and check that they are breathing normally. Do not give food, drink, or tablets until they are fully alert. Note what happened before the episode, how long awareness seemed lost, injuries, new medicines, skipped meals, and any chest discomfort or palpitations. Arrange prompt clinical review, and bring a complete medicine list. Do not let the person drive until a clinician has assessed the cause.

Call emergency services if the person does not recover promptly, has trouble breathing, chest pain, a severe headache, one-sided weakness, ongoing confusion, repeated episodes, a serious injury, or a seizure lasting several minutes. Urgent assessment is also needed when a blackout occurs during exercise, while sitting or lying down, or with a racing or irregular heartbeat. Older adults can have serious causes without dramatic warning symptoms.

Ask whether blood pressure should be checked lying and standing, whether an electrocardiogram or blood tests are appropriate, and whether any medicine could be contributing. Discuss hydration, diabetes management, fall prevention, and whether a heart monitor or neurological review is needed.