Malik, MarekMarekMalikSteger, AlexanderAlexanderStegerDommasch, MichaelMichaelDommaschMüller, AlexanderAlexanderMüllerSinnecker, DanielDanielSinneckerHuster, Katharina MKatharina MHusterGotzler, TeresaTeresaGotzlerGotzler, OthmarOthmarGotzlerHapfelmeier, AlexanderAlexanderHapfelmeierUlm, KurtKurtUlmBarthel, PetraPetraBarthelHnatkova, KaterinaKaterinaHnatkovaLaugwitz, Karl-LudwigKarl-LudwigLaugwitzSchmidt, GeorgGeorgSchmidt2021-01-082021-01-082021-05Europace, 2021, 23 (5), pp.789-7961099-5129http://hdl.handle.net/10044/1/85364Aims Present society is constantly ageing and elderly frequently suffer from conditions that are difficult and/or costly to treat if detected late. Effective screening of the elderly is therefore needed so that those requiring detailed clinical work-up are identified early. We present a prospective validation of a screening strategy based on a Polyscore of seven predominantly autonomic, non-invasive risk markers. Methods and results Within a population-based survey in Germany (INVADE study), participants aged ≥60 years were enrolled between August 2013 and February 2015. Seven prospectively defined Polyscore components were obtained during 30-min continuous recordings of electrocardiogram, blood pressure, and respiration. Out of 1956 subjects, 168 were excluded due to atrial fibrillation, implanted pacemaker, or unsuitable recordings. All-cause mortality over a median 4-year follow-up was prospectively defined as the primary endpoint. The Polyscore divided the investigated population (n = 1788, median age: 72 years, females: 58%) into three predefined groups with low (n = 1405, 78.6%), intermediate (n = 326, 18.2%), and high risk (n = 57, 3.2%). During the follow-up, 82 (4.6%) participants died. Mortality in the Polyscore-defined risk groups was 3.4%, 7.4%, and 17.5%, respectively (P < 0.0001). The Polyscore-based mortality prediction was independent of Framingham score, diabetes, chronic kidney disease, and major stroke and/or myocardial infarction history. It was particularly effective in those aged <75 years (n = 1145). Conclusion The Polyscore-based mortality risk assessment from short-term non-invasive recordings is effective in the elderly general population, especially those aged 60–74 years. Implementation of a comprehensive Polyscore screening of this age group is proposed to advance preventive medical care.© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/),which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contactjournals.permissions@oup.comAutonomic markersElderly general populationPolyscoreProspective validationRisk assessmentCardiovascular System & Hematology1103 Clinical SciencesJournal Articlehttps://www.dx.doi.org/10.1093/europace/euaa359https://academic.oup.com/europace/article/23/5/789/6024429NH/16/2/32499