Mortality predictors in community-dwelling centenarians through comprehensive geriatric assessment

There has been a steady rise in the global population of centenarians. However, information on the factors affecting survival in community-dwelling centenarians remains limited. Comprehensive geriatric assessment (CGA), with its multidisciplinary approach, offers important advantages in identifying predictors of mortality in older adults. This research sought to determine the most common chronic diseases and factors associated with mortality in community-dwelling centenarians using the CGA. The clinical documentation of community-dwelling individuals aged ≥ 100 years who attended a tertiary geriatric outpatient clinic between December 2016 and March 2025 were reviewed. Demographic characteristics, chronic diseases, geriatric syndromes, Charlson Comorbidity Index (CCI), anticholinergic cognitive burden (ACB) score, and laboratory findings at baseline were recorded. Mortality status was followed for 24 months via the National Death Registry and family reports. Multivariate logistic regression was employed to evaluate the independent factors linked to mortality. The study population comprised 65 centenarians (mean age, 102.3 ± 3.3 years; 87.7% female). The two-year all-cause mortality rate was 69.2% (n = 45). The most common chronic diseases were hypertension (66.2%), chronic kidney disease (35.4%), and diabetes mellitus (16.9%). The most prevalent geriatric syndromes were urinary incontinence (60.0%), insomnia (33.8%), and dementia (26.2%). In multivariate analysis, insomnia (OR = 6.04; 95% CI: 1.16–31.4; p = 0.03) and pressure ulcers (OR = 11.9; 95% CI: 1.03–138.2; p = 0.04) were identified as independent predictors of mortality. Sensitivity analyses excluding individuals aged ≥ 110 years and those with hyperpolypharmacy confirmed these associations. In community-dwelling centenarians, insomnia and pressure ulcers are independent factors that significantly increase the risk of two-year mortality. These syndromes may reflect frailty and reduced physiological reserve in advanced age. Early diagnosis and targeted management provided by CGA may contribute to improved survival and quality of life in this vulnerable population.