Dr. Roach: Fainting is more likely as we age

Keith Roach
To Your Health

Dear Dr. Roach: I recently fainted for the first time in my life, requiring a trip to the emergency room. There I was diagnosed with acute syncope. I am 95 years old and in pretty good health, with my numbers being all good. My blood pressure and heart rate are fine. I walk and exercise a little every day, and I have had three cardiac stents. What can I do to prevent such attacks in the future? I was advised that this episode resulted from dehydration, so I am drinking two to three glasses of water a day. This was a very scary experience.

— E.Z.

Dear E.Z.: “Syncope” (from the Greek roots meaning “cut short”) is the medical term for sudden loss of consciousness. Most cases are due to a drop in blood pressure leading to poor blood flow to the brain. There are many possible underlying causes, but the most common is a condition called vasovagal syncope, also known as a common faint.

Dr. Keith Roach

We think of fainting, perhaps based off of media depictions, as a condition of young people, but the older you are, the more likely you are to faint. As we age, the body’s ability to regulate tension in the blood vessels to rapidly adjust to different needs under different body positions decreases. We need more time to adjust.

I recommend sitting for a minute after laying, then standing and making sure of oneself before walking. Many people get warning signs of fainting, such as lightheadedness, nausea, blurry sight or dimming vision, or a “whooshing” sound in the ears. If this happens, sit down right away. You often can avoid a faint or at least a fall.

Dear Dr. Roach: I am proud that I have given blood on a somewhat regular basis for nearly 60 years. As soon as it’s been 58 days since my last whole blood donation, the blood bank starts sending me emails and phone messages urging me to donate again. They have been very aggressive lately because of the shortage of blood drives and donors due to the coronavirus. However, the older I get, the more I feel “drained” after a blood donation.

The eight-week interval between blood donations rule is the same for an 18-year-old as for a 78-year-old. I am in good health, but I don’t feel that my body can replenish its blood supply as efficiently now as it did years ago. Am I too old to donate blood?

— R.W.

Dear R.W.: There is no upper age limit for donating blood, but you shouldn’t donate blood more often than you are comfortable doing so. Sixty years of donating blood is a record to be proud of.

The bone marrow is normally able to replenish the red blood cells that you donate after six weeks, but it might be prudent to have your doctor check your blood counts and iron studies next time you have a visit. The blood bank does check your blood count before you donate to make sure it’s safe, but your counts still might be lower than your normal.

You also can donate on a schedule that you like, whether it’s eight weeks, 12 weeks or never again. If you do choose to donate again, though, thank you on behalf of our patients who need the blood. For readers out there who have never given blood (most haven’t), consider taking some of the load off R.W. and other regular donors.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.