Age- and Sex-Related Electrocardiographic Abnormalities in Homebound Adults Aged ≥80 Years

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Electrocardiographic abnormalities in homebound oldest-old adults (n=556). Intervention: Age ≥90 years vs. Age 80–89 years. Primary outcome: Arrhythmia prevalence (OR 1.60, 95% CI 1.01-2.53, p=0.046).

Q: What does this research mean for the field?

In homebound older adults aged ≥80 years, cardiac arrhythmias are significantly more prevalent in those aged ≥90 years compared to those aged 80–89 years. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Andrea E. Montero; Jesús Morales; Styp B. Canto; Marco A. Mascaro

doi:10.21203/rs.3.rs-10881821/v2

October 21, 2026Open Access

Age- and Sex-Related Electrocardiographic Abnormalities in Homebound Adults Aged ≥80 Years

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Key result

Age ≥90 linked to ~60% higher odds of cardiac arrhythmias in homebound older adults.

OR 1.60
95% CI 1.01-2.53
P=0.046
n=556

Why the study?

This study sought to characterize age- and sex-related electrocardiographic abnormalities in homebound adults aged ≥80 years evaluated by tele-electrocardiography.

Does advancing age (≥90 vs 80–89 years) or sex affect the prevalence of electrocardiographic abnormalities such as arrhythmias and conduction blocks in homebound adults aged ≥80 years evaluated by tele-electrocardiography?

Key Points

To assess the prevalence of age- and sex-related electrocardiographic abnormalities among homebound adults aged 80 years and older evaluated via tele-electrocardiography.
Cross-sectional evaluation of remote electrocardiograms (ECGs) from 556 homebound adults aged ≥80 years (326 aged 80–89 years, 230 aged ≥90 years; 370 women, 186 men) in Peru.
Assessed rhythm and electrical disturbances across age categories (80–89 versus ≥90 years) and analyzed sex-stratified rates of conduction block.
Arrhythmias were significantly more frequent in individuals aged ≥90 years than those aged 80–89 years (19.6% vs 13.2%; OR 1.60, 95% CI 1.01–2.53; p=0.046).
Among individuals aged 80–89 years, conduction block was more frequent in men than women (23.7% vs 13.0%; OR 2.09, 95% CI 1.16–3.75; p=0.020), but rates converged at ≥90 years (20.6% vs 20.4%; OR 1.01, 95% CI 0.50–2.04; p=1.000; age-by-sex interaction p=0.122).
Other abnormalities, including ventricular hypertrophy (12.6% vs 15.7%; p=0.320) and bradycardia or tachycardia (13.2% vs 11.7%; p=0.697), showed no statistically significant differences between age groups.

Study Design

Type

Cross-Sectional (n=556)

Multicenter

No

Structured PICO

Does advancing age (≥90 vs 80–89 years) or sex affect the prevalence of electrocardiographic abnormalities such as arrhythmias and conduction blocks in homebound adults aged ≥80 years evaluated by tele-electrocardiography?

P

Population

556 homebound adults aged ≥80 years (66.5% female; 58.6% aged 80–89 and 41.4% aged ≥90) in Peru evaluated via a remote tele-electrocardiography service in a cross-sectional analysis.

E

Exposure

Tele-electrocardiography (TeleECG) evaluation and stratification by age (≥90 years) and sex

C

Comparator

Aged 80–89 years (and comparison between women and men within age groups)

O

Outcome

Prevalence of electrocardiographic abnormalities recorded as binary outcomes in the clinical database, including arrhythmia and conduction block (comprising atrioventricular block and bundle branch block)surrogate

Main Result

Odds Ratio: 1.6 (95% CI 1.01–2.53)

Absolute Event Rate: 19.6% vs 13.2%

p-value: p=0.046

In homebound adults aged ≥80 years evaluated via tele-electrocardiography, arrhythmia burden continues to rise at ≥90 years, while the higher prevalence of conduction block seen in men aged 80–89 years appears to converge between sexes at ≥90 years.

Limitations

Retrospective design depended on diagnostic categories recorded in routine care without standardized adjudication of individual ECG tracings
Clinical covariates such as cardiovascular diagnoses, medications, symptoms, and prior pacing were not incorporated
Longitudinal outcomes were unavailable
Single tele-electrocardiography pathway may limit generalizability
Multiple ECG categories and stratified comparisons were examined without adjustment for multiplicity
Retrospective design depended on diagnostic categories recorded in routine care and did not permit standardized adjudication of individual ECG tracings
Based on a single tele-electrocardiography pathway, which may limit generalizability

Implication

May support arrhythmia monitoring in homebound nonagenarians; hypothesis-generating for prospective validation in frail elderly.

Abstract

We examined age- and sex-related electrocardiographic abnormalities in 556 adults aged ≥80 years evaluated by tele-electrocardiography. Arrhythmias were more frequent at ≥90 than at 80–89 years (19.6% vs 13.2%; OR 1.60, 95% CI 1.01–2.53). Among adults aged 80–89 years, conduction block was more frequent in men than women (23.7% vs 13.0%; OR 2.09, 95% CI 1.16–3.75), whereas prevalence was similar between sexes at ≥90 years (20.6% vs 20.4%). These findings suggest age-related changes in arrhythmia burden and exploratory sex-related patterns in conduction abnormalities at very advanced age.

Discussion

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Cite This Study

Montero et al. (2026) conducted a cross-sectional in Electrocardiographic abnormalities in homebound oldest-old adults (n=556). Age ≥90 years vs. Age 80–89 years was evaluated on Arrhythmia prevalence (OR 1.60, 95% CI 1.01-2.53, p=0.046). Age ≥90 years was associated with a higher prevalence of cardiac arrhythmias compared to age 80–89 years (19.6% vs 13.2%; OR 1.60, 95% CI 1.01–2.53; p=0.046) in homebound older adults.

synapsesocial.com/papers/6ae28f3bcbadf70daf6c4439 https://doi.org/10.21203/rs.3.rs-10881821/v2

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Age- and Sex-Related Electrocardiographic Abnormalities in Homebound Adults Aged ≥80 Years

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Age- and Sex-Related Electrocardiographic Abnormalities in Homebound Adults Aged ≥80 Years

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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