title: Electrocardiographic abnormalities in centenarians: impact on survival.
abstract: BACKGROUND
  The centenarian population is gradually increasing, so it is becoming more common to see centenarians in clinical practice. Electrocardiogram abnormalities in the elderly have been reported, but several methodological biases have been detected that limit the validity of their results. The aim of this study is to analyse the ECG abnormalities in a prospective study of the centenarian population and to assess their impact on survival.
  
  
  METHODS
  We performed a domiciliary visit, where a medical history, an ECG and blood analysis were obtained. Barthel index (BI), cognitive mini-exam (CME) and Charlson index (ChI) were all determined. Patients were followed up by telephone up until their death.
  
  
  RESULTS
  A total of 80 centenarians were studied, 26 men and 64 women, mean age 100.8 (SD 1.3). Of these, 81% had been admitted to the hospital at least once in the past, 81.3% were taking drugs (mean 3.3, rank 0-11). ChI was 1.21 (SD 1.19). Men had higher scores both for BI (70 -SD 34.4- vs. 50.4 -SD 36.6-, P = .005) and CME (16.5 -SD 9.1- vs. 9.1 -SD 11.6-, P = .008); 40.3% of the centenarians had anaemia, 67.5% renal failure, 13% hyperglycaemia, 22.1% hypoalbuminaemia and 10.7% dyslipidaemia, without statistically significant differences regarding sex. Only 7% had a normal ECG; 21 (26.3%) had atrial fibrillation (AF), 30 (37.5%) conduction defects and 31 (38.8%) abnormalities suggestive of ischemia, without sex-related differences. A history of heart disease was significantly associated with the presence of AF (P = .002, OR 5.2, CI 95% 1.8 to 15.2) and changes suggestive of ischemia (P = .019, OR 3.2, CI 95% 1.2-8.7). Mean survival was 628 days (SD 578.5), median 481 days. Mortality risk was independently associated with the presence of AF (RR 2.0, P = .011), hyperglycaemia (RR 2.2, P = .032), hypoalbuminaemia (RR 3.5, P < .001) and functional dependence assessed by BI (RR 1.8, P = .024).
  
  
  CONCLUSIONS
  Although ECG abnormalities are common in centenarians, they are not related to sex, functional capacity or cognitive impairment. The only abnormality that has an impact on survival is AF.
authors.affiliation: Internal Medicine Department, Lucus Augusti University Hospital (HULA), SERGAS, San Cibrao, s/n, 27003, Lugo, Spain. ramon.rabunal.rey@sergas.es
authors.forename: Ramón
authors.initials: R
authors.lastname: Rabuñal-Rey
authors.forename: Rafael
authors.initials: R
authors.lastname: Monte-Secades
authors.forename: Adriana
authors.initials: A
authors.lastname: Gomez-Gigirey
authors.forename: Sonia
authors.initials: S
authors.lastname: Pértega-Díaz
authors.forename: Ana
authors.initials: A
authors.lastname: Testa-Fernández
authors.forename: Salvador
authors.initials: S
authors.lastname: Pita-Fernández
authors.forename: Emilio
authors.initials: E
authors.lastname: Casariego-Vales
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000401:mortality*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000401:mortality; D060825:Cognitive Dysfunction / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012306:Risk; D012737:Sex Factors; D016019:Survival Analysis