We studied the significance for further survival of heart rate variability and other variables in the very elderly. In 1992, we assessed activities of daily living, cognitive function, and nutritional status in 27 centenarians with no disease, in addition to the power of the heart rate variability in the ultralow, very low, low (LF), and high frequency (HF) bands. In 1996, we assessed survival in these centenarians; 17 had died and 10 were still living. Logistic regression analysis using backward elimination detected three factors, dementia, LF/HF, and age, that independently influenced mortality. Mortality risk increased with greater age in 1992, more severe dementia, or lower LF/HF. Sympathetic nerve activity, represented as LF/HF, may be associated with prognosis for survival in centenarians.