title: Major electrocardiographic abnormality predicts support/care-need certification and/or death in community-dwelling older adults with no history of cardiovascular disease.
abstract: OBJECTIVE
  Not only cardiovascular disease (CVD) itself, but also subclinical major electrocardiographic (ECG) abnormalities are related to frailty in older adults. We investigated whether major ECG abnormality was associated with first support/care-need certification in Long-Term Care Insurance or death in community-dwelling older adults.
  
  
  METHODS
  We analyzed 1078 community-dwelling older adults with no history of certification aged 65-94 years. Relationships between baseline major ECG abnormality and risk of first certification or death were estimated using the Cox proportional hazards model.
  
  
  RESULTS
  During 5 years, 135 first certifications and 53 deaths occurred. Among participants with no prior history of CVD (n = 875), those with major ECG abnormality (n = 282) showed significantly higher adjusted hazard ratios (HR) for certification (HR 2.42, 95% CI 1.58-3.69, P < 0.001) and for death (HR 2.44, 95% CI 1.27-4.69, P = 0.008) compared with control participants without major ECG abnormality (n = 593). The impact of major ECG abnormality on certification in this group was more evident in older adults with age ≥75 years, female sex or hyperuricemia. Participants with either arrhythmia or ST/T abnormality on ECG examination tended to have higher HR for certification as a result of dementia. In participants with a prior history of CVD (n = 203), the impact of major ECG abnormality (n = 126) on certification was not significant.
  
  
  CONCLUSIONS
  These observations show that subclinical major ECG abnormality predicts higher risk for later support/care-need certification in community-dwelling older adults with no prior history of CVD. Geriatr Gerontol Int 2017; 17: 1967-1976.
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Tazuo
authors.initials: T
authors.lastname: Okuno
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Kumie
authors.initials: K
authors.lastname: Nakajima
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Iritani
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yano
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Taroh
authors.initials: T
authors.lastname: Himeno
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Igarashi
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Okuro
authors.affiliation: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Morimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology*; D003643:Death; D004562:Electrocardiography; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D057187:Independent Living; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment
keywords: cardiovascular disease; certification; dementia; elderly; electrocardiography