title: Cognitive performance and functional status are the major factors predicting survival of centenarians in Poland.
abstract: BACKGROUND
  Clinical and biochemical predictors of extreme longevity would be useful in geriatric practice but have still not been clearly defined.
  
  
  METHODS
  To identify the best nongenetic predictors of survival in centenarians, we examined 340 individuals aged 100+ years. A detailed questionnaire was completed, and comprehensive geriatric assessment and blood analyses were performed. Survival of study participants was checked annually over the period of 10 years.
  
  
  RESULTS
  In the univariate Cox proportional hazards model, a longer survival of centenarians was correlated with a higher adjusted Mini-Mental State Examination (MMSE(adj)) score (p < .000001), higher Activities of Daily Living (ADL) and adjusted Instrumental Activities of Daily Living (IADL(adj)) scores (p < .000001 and p = .00008, respectively), and younger age at the time of testing (p = .005). Blood pressure, lipid profile, and C-reactive protein and hemoglobin concentrations were not associated with survival. Multivariate analysis including age, sex, and the MMSE(adj) and ADL scores showed that both MMSE(adj) and ADL predicted survival (HR = 0.978 per each MMSE(adj) point, 95% CI: 0.964-0.993, p = .004; HR = 0.900 per each ADL point, 95% CI: 0.842-0.962, p = .002, respectively). In multivariate analysis with the ADL score substituted by the IADL(adj) score, the only predictor of survival was MMSE(adj) (HR = 0.973 per each MMSE(adj) point, 95% CI: 0.958-0.988, p = .0006).
  
  
  CONCLUSIONS
  Cognitive and functional performances are predictors of survival in centenarians.
authors: PolStu Project, International Institute of Molecular and Cell Biology, Warsaw, Poland.
authors: Malgorzata
authors: M
authors: Mossakowska
authors: Department of Geriatrics, Medical University of Warsaw, Poland.
authors: Katarzyna
authors: K
authors: Broczek
authors: Department of Palliative Medicine, Poznan University of Medical Sciences, Poland.
authors: Katarzyna
authors: K
authors: Wieczorowska-Tobis
authors: Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University, Cracow, Poland.
authors: Alicja
authors: A
authors: Klich-Rączka
authors: Department of Human Epigenetics, Mossakowski Medical Research Centre, Warsaw, Poland.
authors: Marta
authors: M
authors: Jonas
authors: Department of Human Epigenetics, Mossakowski Medical Research Centre, Warsaw, Poland. Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, Warsaw, Poland.
authors: Eliza
authors: E
authors: Pawlik-Pachucka
authors: Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.
authors: Krzysztof
authors: K
authors: Safranow
authors: Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology, Warsaw, Poland.
authors: Jacek
authors: J
authors: Kuznicki
authors: Department of Human Epigenetics, Mossakowski Medical Research Centre, Warsaw, Poland. Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, Warsaw, Poland. mpuzianowska@wum.edu.pl.
authors: Monika
authors: M
authors: Puzianowska-Kuznicka
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D005260:Female; D006801:Humans; D008136:Longevity; D008297:Male; D015999:Multivariate Analysis; D011044:Poland; D016016:Proportional Hazards Models
keywords: Centenarians; Katz Activities of Daily Living; Lawton Instrumental Activities of Daily Living.; Mini-Mental State Examination; Survival