Association between reduced heart rate variability and cognitive impairment in older disabled women in the community: Women's Health and Aging Study I
Association between reduced heart rate variability and cognitive impairment in older disabled women in the community: Women's Health and Aging Study I
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DOI：
10.1111/j.1532-5415.2006.00940.x
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发表时间：
2006-11-01
影响因子：
6.3
通讯作者：
Chaves, Paulo H. M.
中科院分区：
文献类型：
--
作者：
Kim, Dae Hyun;Lipsitz, Lewis A.;Chaves, Paulo H. M.
研究心率变异性（HRV）（心脏自主神经功能的标志物）与认知功能障碍之间的独立关联。来自马里兰州巴尔的摩城市社区妇女健康与老龄化研究I的基线数据的横断面分析。社区-心率变异性降低的定义为几种心率变异性指标中每一种的最低四分位数，频率域，并与其余三个四分位数进行比较。认知障碍定义为简易精神状态检查评分低于24分。多元Logistic回归分析显示HRV降低与认知功能损害之间的独立关系，HRV降低者的认知功能损害患病率在年龄、教育程度和种族方面均高于非HRV降低者。在调整相关人口统计学和临床特征后，HRV降低的参与者比HRV未降低的参与者更有可能患有认知障碍;这些结果在不同的HRV指标中是一致的。特别是，高频功率降低，表明副交感神经活动减少，与6.7倍的认知功能障碍的几率（95%置信区间= 2.27-20.0）。心脏自主神经功能障碍，特别是副交感神经活动减少，与社区老年残疾妇女的认知功能障碍独立相关。这一发现可能会提高认知障碍的病理生理基础的理解。HRV作为认知障碍的原因或后果的潜在作用需要在未来的研究中阐明。
To examine the independent association between heart rate variability (HRV), a marker of cardiac autonomic function, and cognitive impairment.Cross-sectional analysis of baseline data from Women's Health and Aging Study I.Urban community in Baltimore, Maryland.A subset of 311 physically disabled, community-dwelling women aged 65 and older whose HRV data were obtained.Reduced HRV was defined as the lowest quartile of each of several HRV measures exploring time and frequency domains and compared with the remaining three quartiles. Cognitive impairment was defined as a Mini-Mental State Examination score less than 24. Multiple logistic regression was used to model the independent relationship between reduced HRV and prevalent cognitive impairment.The age-, education-, and race-adjusted prevalence of cognitive impairment was higher in those with reduced HRV than in those with nonreduced HRV. After adjusting for relevant demographic and clinical characteristics, participants with reduced HRV were significantly more likely than those with nonreduced HRV to have cognitive impairment; these findings were consistent across different HRV indices. In particular, reduced high-frequency power, indicative of decreased parasympathetic activity, was associated with 6.7 times greater odds of cognitive impairment (95% confidence interval = 2.27-20.0).Cardiac autonomic dysfunction, particularly decreased parasympathetic activity, was independently associated with cognitive impairment in older disabled women in the community. This finding may improve understanding of the pathophysiological basis of cognitive impairment. The potential role of HRV as a cause or consequence of cognitive impairment needs to be elucidated in future studies.