Introduction: Presence of cardiovascular disease is linked to the prevalence and incidence of motoric cognitive risk (MCR) syndrome, a pre-dementia syndrome characterized by cognitive complaints and slow gait. Electrocardiograms (ECGs) may offer a cost-effective, noninvasive, and reliable method for detecting cardiovascular abnormalities in individuals with MCR. This approach can not only diagnose cardiovascular disease but also facilitate timely interventions to prevent further cognitive decline in MCR cases. Methods: We examined the association of ECG abnormalities with prevalent MCR in 451 older adults with ECGs participating in the Kerala-Einstein Study (KES), based in Indian state of Kerala. Logistic regression analysis adjusted for age and sex was used to examine associations and reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: ECG abnormalities were present in 191 (42.4%) participants. Of the 43 participants diagnosed with MCR, 23 (53.5%) had ECG abnormalities. Abnormal Q waves (OR 5.1, 95% CI: 1.7–14.9) and heart block (OR 6.0, 95% CI: 2.1–17.4) were more common in individuals with MCR compared to controls. There were no statistically significant group differences in the prevalence of other ECG abnormalities. Conclusion: ECG abnormalities are common in MCR patients and can be considered for cardiovascular disease risk stratification in MCR cases.

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