Resting heart rate and cognitive function in ageing: Insights from a secondary data analysis

Resting heart rate (RHR) is an accessible measure that may reflect age-related cardiovascular and autonomic dysregulation relevant to cognitive ageing. However, evidence linking RHR with cognitive outcomes is inconsistent, and most studies relied on single baseline measurements that may not capture cumulative exposure. This study examined the associations of baseline and longitudinally averaged RHR with cognitive decline and dementia in older adults. This was a secondary analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) study, including 19,114 community-dwelling participants aged ≥ 65 years without cardiovascular disease or dementia at baseline. RHR was assessed at baseline and follow-up visits using an oscillometric device. Cognitive decline was defined as a decrease of > 1.5 standard deviations from baseline performance in global cognition, episodic memory, psychomotor speed, or verbal fluency. Incident dementia was adjudicated using DSM-IV criteria. Compared with baseline RHR of 60-69 bpm, those with RHR ≥ 80 bpm had a 9% higher cognitive decline risk (hazard ratio [HR] 1.09; 95% confidence interval [CI], 1.01-1.18). Five-year average RHR of 70-79 bpm and ≥ 80 bpm were associated with 10% (HR 1.10; 95% CI, 1.03-1.19) and 16% (HR 1.16; 95% CI, 1.05-1.28) higher cognitive decline risks, respectively. No significant associations were observed with incident dementia. Higher RHR was associated with increased risk of cognitive decline among older adults. These findings suggest that elevated RHR may reflect age-related cardiovascular or autonomic physiological processes relevant to cognitive aging, supporting a role for late-life physiological dysregulation in cognitive trajectories.