Key result
Increased sympathetic activity, indicated by higher long-term heart rate variability parameters such as SDNN, was significantly associated with better cognitive performance in older adults.
Why the study?
Age-related cardiac autonomic changes frequently co-occur with cognitive impairment in older adults and may interfere with cognitive domain control, motivating evaluation of the link between long-term heart rate variability and cognitive performance.
Does long-term heart rate variability correlate with cognitive performance in elderly outpatients?
Cross-Sectional (n=117)
No
Does long-term heart rate variability correlate with cognitive performance in elderly outpatients?
Effect estimate: r=0.481
p-value: p=<0.001
In elderly outpatients, increased sympathetic activity measured by long-term heart rate variability is associated with better cognitive performance.
Should not yet change clinical practice in elderly outpatients; leaves open whether sympathetic modulation affects cognitive trajectories.
BACKGROUND In geriatric age, cognitive impairment and cardiovascular disorders are frequent comorbidities. Age-related anatomical and functional cardiac changes, including the autonomic system, could interfere with the control of different cognitive domains. Therefore, we assess the relationship between long-term heart rate variability (HRV), as measure of autonomic nervous system (ANS) functioning, and cognitive performances, in elderly patients representative of the outpatients in a real-life setting. METHODS Of 155 elderly outpatients (aged >65) screened, 117 enrolled patients underwent anthropometric evaluation, cardiac assessment by 12-leads electrocardiogram, 24-hour ECG recording and blood pressure (BP) measurement as well as global cognitive evaluation by a standardized multidimensional assessment, including Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment test (MoCA). HRV analysis was performed on 24-hour ECG recordings focusing on Time-domain indices (SDNN, SDANN and RMSSD) and on Frequency-domain measurements (HR, LF, HF, LF/HF). Multivariate linear analysis was used to explore the influence of the HRV significant variables on MMSE and MoCA test values. RESULTS MMSE and MoCA scores were both significantly and positively correlated with sympathetic system parameters (SDNN, SDANN, LF and LF/HF ratio) but not with parasympathetic system (rMSSD and HF) parameters. Multivariate analysis confirms this relationship. CONCLUSIONS Our results show that, in a representative real-life community elderly population, increased sympathetic activity, but not decreased vagal activity is associated with better cognitive performances. These results support the sympathetic autonomic function, in that the relationship between better cognitive performances and moderate prevalence of autonomic function appears dependent on long-term changes in heart rate, mediated by sympathetic activation.
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Dalise et al. (2020) conducted a cross-sectional in Cognitive Impairment (n=117). Long-term heart rate variability (HRV) was evaluated on Correlation between sympathetic HRV parameter (SDNN) and Montreal Cognitive Assessment (MoCA) score (r=0.481, p=<0.001). Increased sympathetic activity, indicated by higher long-term heart rate variability parameters such as SDNN, was significantly associated with better cognitive performance in older adults.
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