Skip to main content

Advertisement

SpringerLink
Log in

Cognitive function is associated with impaired heart rate variability in ageing adults: the Irish longitudinal study on ageing wave one results

  • Research Article
  • Published:
Clinical Autonomic Research Aims and scope Submit manuscript

Abstract

Objective

To examine the independent association between heart rate variability (HRV) and cognitive performance, in a nationally representative population study of older adults.

Methods

Cross-sectional analysis of wave 1 data from the Irish longitudinal study on ageing (TILDA) was performed. A subset of 4,763 participants who underwent ECG recording during resting and paced breathing periods were used for the analysis. HRV indices were divided into quintiles for comparison of values and cognitive performance was defined using the Montreal cognitive assessment (MOCA) score. Multivariate linear regression was used to model the association between cognition and different quintiles of each HRV index, after adjustment for covariates.

Results

The mean age was 61.7 ± 8.3 years and 2,618 (55 %) were female. Lower quintiles of SDNN (P = 0.01-paced), LF (P = 0.001-paced), and LF:HF ratio (P = 0.049-paced) were significantly associated with lower MOCA scores (during both recording periods), independent of confounders. Sub-domains of MOCA responsible for the relationship were predominantly memory recall and language.

Interpretation

Reduced HRV is significantly associated with lower cognitive performance at a population level in people aged 50 and older. This further strengthens the relationship between autonomic dysfunction and cognitive disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Baumert M, Lambert GW, Dawood T, Lambert EA, Esler MD, McGrane M, Barton D, Nalivaiko E (2008) QT interval variability and cardiac norepinephrine spillover in patients with depression and panic disorder. Am J Physiol Heart circulatory physiol 295(3):H962–H968. doi:10.1152/ajpheart.00301.2008

    Article  CAS  Google Scholar 

  2. Bischkopf J, Busse A, Angermeyer MC (2002) Mild cognitive impairment—a review of prevalence, incidence and outcome according to current approaches. Acta Psychiatr Scand 106(6):403–414

    Article  PubMed  CAS  Google Scholar 

  3. Britton A, Singh-Manoux A, Hnatkova K, Malik M, Marmot MG, Shipley M (2008) The association between heart rate variability and cognitive impairment in middle-aged men and women. The Whitehall II cohort study. Neuroepidemiology 31(2):115–121. doi:10.1159/000148257

    Article  PubMed  Google Scholar 

  4. Camm AJ, Kirchhof P, Lip GYH, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B (2010) Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European society of cardiology (ESC). Europace 12(10):1360–1420

    Article  PubMed  Google Scholar 

  5. Carnethon MR, Golden SH, Folsom AR, Haskell W, Liao D (2003) Prospective investigation of autonomic nervous system function and the development of type 2 diabetes: the atherosclerosis risk in communities study, 1987–1998. Circulation 107(17):2190–2195. doi:10.1161/01.cir.0000066324.74807.95

    Article  PubMed  Google Scholar 

  6. Castle M, Comoli E, Loewy AD (2005) Autonomic brainstem nuclei are linked to the hippocampus. Neuroscience 134(2):657–669. doi:10.1016/j.neuroscience.2005.04.031

    Article  PubMed  CAS  Google Scholar 

  7. Coen RF, Cahill R, Lawlor BA (2011) Things to watch out for when using the Montreal cognitive assessment (MoCA). Int J Geriatr Psychiatry 26(1):107–108. doi:10.1002/gps.2471

    Article  PubMed  Google Scholar 

  8. Cui Y, Liu B, Luo S, Zhen X, Fan M, Liu T, Zhu W, Park M, Jiang T, Jin JS, The Alzheimer’s Disease Neuroimaging, I (2011) Identification of conversion from mild cognitive impairment to Alzheimer’s disease using multivariate predictors. PLoS ONE 6(7):e21896. doi:10.1371/journal.pone.0021896

    Article  PubMed  CAS  Google Scholar 

  9. Electrophysiology, T.F.o.t.E.S.o.C.t.N.A.S.o.P. (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 93(5):1043–1065. doi:10.1161/01.cir.93.5.1043

    Article  Google Scholar 

  10. Elias MF, Goodell AL, Dore GA (2012) Hypertension and cognitive functioning: a perspective in historical context. Hypertension 60(2):260–268

    Article  PubMed  CAS  Google Scholar 

  11. Ewers M, Walsh C, Trojanowski JQ, Shaw LM, Petersen RC, Jack CR Jr, Feldman HH, Bokde AL, Alexander GE, Scheltens P, Vellas B, Dubois B, Weiner M, Hampel H (2012) Prediction of conversion from mild cognitive impairment to Alzheimer’s disease dementia based upon biomarkers and neuropsychological test performance. Neurobiol Aging 33(7):1203–1214. doi:10.1016/j.neurobiolaging.2010.10.019

    Article  PubMed  CAS  Google Scholar 

  12. Felber Dietrich D, Schindler C, Schwartz J, Barthelemy JC, Tschopp JM, Roche F, von Eckardstein A, Brandli O, Leuenberger P, Gold DR, Gaspoz JM, Ackermann-Liebrich U (2006) Heart rate variability in an ageing population and its association with lifestyle and cardiovascular risk factors: results of the SAPALDIA study. Europace 8(7):521–529. doi:10.1093/europace/eul063

    Article  PubMed  Google Scholar 

  13. Hollingworth P, Harold D, Sims R, Gerrish A, Lambert JC, Carrasquillo MM, Abraham R, Hamshere ML, Pahwa JS, Moskvina V, Dowzell K, Jones N, Stretton A, Thomas C, Richards A, Ivanov D, Widdowson C, Chapman J, Lovestone S, Powell J, Proitsi P, Lupton MK, Brayne C, Rubinsztein DC, Gill M, Lawlor B, Lynch A, Brown KS, Passmore PA, Craig D, McGuinness B, Todd S, Holmes C, Mann D, Smith AD, Beaumont H, Warden D, Wilcock G, Love S, Kehoe PG, Hooper NM, Vardy ER, Hardy J, Mead S, Fox NC, Rossor M, Collinge J, Maier W, Jessen F, Ruther E, Schurmann B, Heun R, Kolsch H, van den Bussche H, Heuser I, Kornhuber J, Wiltfang J, Dichgans M, Frolich L, Hampel H, Gallacher J, Hull M, Rujescu D, Giegling I, Goate AM, Kauwe JS, Cruchaga C, Nowotny P, Morris JC, Mayo K, Sleegers K, Bettens K, Engelborghs S, De Deyn PP, Van Broeckhoven C, Livingston G, Bass NJ, Gurling H, McQuillin A, Gwilliam R, Deloukas P, Al-Chalabi A, Shaw CE, Tsolaki M, Singleton AB, Guerreiro R, Muhleisen TW, Nothen MM, Moebus S, Jockel KH, Klopp N, Wichmann HE, Pankratz VS, Sando SB, Aasly JO, Barcikowska M, Wszolek ZK, Dickson DW, Graff-Radford NR, Petersen RC, van Duijn CM, Breteler MM, Ikram MA, DeStefano AL, Fitzpatrick AL, Lopez O, Launer LJ, Seshadri S, Berr C, Campion D, Epelbaum J, Dartigues JF, Tzourio C, Alperovitch A, Lathrop M, Feulner TM, Friedrich P, Riehle C, Krawczak M, Schreiber S, Mayhaus M, Nicolhaus S, Wagenpfeil S, Steinberg S, Stefansson H, Stefansson K, Snaedal J, Bjornsson S, Jonsson PV, Chouraki V, Genier-Boley B, Hiltunen M, Soininen H, Combarros O, Zelenika D, Delepine M, Bullido MJ, Pasquier F, Mateo I, Frank-Garcia A, Porcellini E, Hanon O, Coto E, Alvarez V, Bosco P, Siciliano G, Mancuso M, Panza F, Solfrizzi V, Nacmias B, Sorbi S, Bossu P, Piccardi P, Arosio B, Annoni G, Seripa D, Pilotto A, Scarpini E, Galimberti D, Brice A, Hannequin D, Licastro F, Jones L, Holmans PA, Jonsson T, Riemenschneider M, Morgan K, Younkin SG, Owen MJ, O’Donovan M, Amouyel P, Williams J (2011) Common variants at ABCA7, MS4A6A/MS4A4E, EPHA1, CD33 and CD2AP are associated with Alzheimer’s disease. Nat Genet 43(5):429–435. doi:10.1038/ng.803

    Article  PubMed  CAS  Google Scholar 

  14. Kearney PM, Cronin H, O’Regan C, Kamiya Y, Savva GM, Whelan B, Kenny R (2011) Cohort profile: the Irish longitudinal study on ageing. Int J Epidemiol 40(4):877–884. doi:10.1093/ije/dyr116

    Article  PubMed  Google Scholar 

  15. Kim DH, Lipsitz LA, Ferrucci L, Varadhan R, Guralnik JM, Carlson MC, Fleisher LA, Fried LP, Chaves PH (2006) Association between reduced heart rate variability and cognitive impairment in older disabled women in the community: women’s Health and Aging Study I. J Am Geriatr Soc 54(11):1751–1757. doi:10.1111/j.1532-5415.2006.00940.x

    Article  PubMed  Google Scholar 

  16. Kim JW, Lee DY, Lee BC, Jung MH, Kim H, Choi YS, Choi IG (2012) Alcohol and cognition in the elderly: a review. Psychiatry Investigation 9(1):8–16. doi:10.4306/pi.2012.9.1.8

    Article  PubMed  CAS  Google Scholar 

  17. Lee JY, Dong Woo L, Cho SJ, Na DL, Hong Jin J, Kim SK, You Ra L, Youn JH, Kwon M, Lee JH, Maeng Je C (2008) Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the montreal cognitive assessment. J Geriatr Psychiatry Neurol 21(2):104–110. doi:10.1177/0891988708316855

    Article  PubMed  Google Scholar 

  18. Li X, Shaffer ML, Rodriguez-Colon SM, He F, Bixler EO, Vgontzas AN, Wolbrette DL, Wu C, Ball RW, Liao D (2011) Systemic inflammation and circadian rhythm of cardiac autonomic modulation. Autonomic Neurosci: Basic Clin 162(1–2):72–76. doi:10.1016/j.autneu.2011.03.002

    Article  Google Scholar 

  19. Mielke MM, Okonkwo OC, Oishi K, Mori S, Tighe S, Miller MI, Ceritoglu C, Brown T, Albert M, Lyketsos CG (2012) Fornix integrity and hippocampal volume predict memory decline and progression to Alzheimer’s disease. Alzheimer’s Dementia: J Alzheimer’s Assoc 8(2):105–113. doi:10.1016/j.jalz.2011.05.2416

    Article  Google Scholar 

  20. Moak JP, Goldstein DS, Eldadah BA, Saleem A, Holmes C, Pechnik S, Sharabi Y (2009) Supine low-frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Clevel Clin J Med 76(Suppl 2):S51–S59. doi:10.3949/ccjm.76.s2.11

    Article  Google Scholar 

  21. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H (2005) The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53(4):695–699. doi:10.1111/j.1532-5415.2005.53221.x

    Article  PubMed  Google Scholar 

  22. Nicolini P, Ciulla MM, De Asmundis C, Magrini F, Brugada P (2012) The prognostic value of heart rate variability in the elderly, changing the perspective: from sympathovagal balance to chaos theory. Pacing Clin Electrophysiol 35(5):622–638. doi:10.1111/j.1540-8159.2012.03335.x

    Article  PubMed  Google Scholar 

  23. Nunan D, Sandercock GR, Brodie DA (2010) A quantitative systematic review of normal values for short-term heart rate variability in healthy adults. Pacing Clin Electrophysiol 33(11):1407–1417. doi:10.1111/j.1540-8159.2010.02841.x

    Article  PubMed  Google Scholar 

  24. Pardey J, Jouravleva S (2004) The next-generation holter revolution: from analyse-edit-print to analyse-print. Comput Cardiol 2004:373–376

    Google Scholar 

  25. Pavlov VA, Tracey KJ (2005) The cholinergic anti-inflammatory pathway. Brain Behav Immun 19(6):493–499. doi:10.1016/j.bbi.2005.03.015

    Article  PubMed  CAS  Google Scholar 

  26. Pinna GD, Maestri R, Torunski A, Danilowicz-Szymanowicz L, Szwoch M, La Rovere MT, Raczak G (2007) Heart rate variability measures: a fresh look at reliability. Clin Sci (Lond) 113(3):131–140

    Article  Google Scholar 

  27. Qiu C, Winblad B, Viitanen M, Fratiglioni L (2003) Pulse pressure and risk of Alzheimer disease in persons aged 75 years and older: a community-based, longitudinal study. Stroke 34(3):594–599. doi:10.1161/01.str.0000060127.96986.f4

    Article  PubMed  Google Scholar 

  28. Radloff LS (1977) The CES-D Scale. Appl Psychol Meas 1(3):385–401. doi:10.1177/014662167700100306

    Article  Google Scholar 

  29. Robertson IH (2013) A noradrenergic theory of cognitive reserve: implications for Alzheimer's disease. Neurobiol Aging 34(1):298–308. doi:10.1016/j.neurobiolaging.2012.05.019

  30. Rountree S, Waring S, Chan W, Lupo P, Darby E, Doody R (2007) Importance of subtle amnestic and nonamnestic deficits in mild cognitive impairment: prognosis and conversion to dementia. Dement Geriatr Cogn Disord 24(6):476–482

    Article  PubMed  CAS  Google Scholar 

  31. Sajadieh A, Nielsen OW, Rasmussen V, Hein HO, Abedini S, Hansen JF (2004) Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J 25(5):363–370. doi:10.1016/j.ehj.2003.12.003

    Article  PubMed  Google Scholar 

  32. Sandercock G, Gladwell V, Dawson S, Nunan D, Brodie D, Beneke R (2008) Association between RR interval and high-frequency heart rate variability acquired during short-term, resting recordings with free and paced breathing. Physiol Meas 29(7):795–802. doi:10.1088/0967-3334/29/7/008

    Article  PubMed  Google Scholar 

  33. Sandercock GRH, Bromley PD, Brodie DA (2005) The reliability of short-term measurements of heart rate variability. Int J Cardiol 103(3):238–247

    Article  PubMed  Google Scholar 

  34. Schram MT, Euser SM, De Craen AJM, Witteman JC, Frolich M, Hofman A, Jolles J, Breteler MMB, Westendorp RGJ (2007) Systemic markers of inflammation and cognitive decline in old age. J Am Geriatr Soc 55(5):708–716

    Article  PubMed  Google Scholar 

  35. Shah AJ, Su S, Veledar E, Bremner JD, Goldstein FC, Lampert R, Goldberg J, Vaccarino V (2011) Is heart rate variability related to memory performance in middle-aged men? Psychosom Med 73(6):475–482. doi:10.1097/PSY.0b013e3182227d6a

    Article  PubMed  Google Scholar 

  36. Simone MJ, Tan ZS (2011) The role of inflammation in the pathogenesis of delirium and dementia in older adults: a review. CNS Neurosci Ther 17(5):506–513

    Article  PubMed  CAS  Google Scholar 

  37. Singh JP, Larson MG, Tsuji H, Evans JC, O’Donnell CJ, Levy D (1998) Reduced heart rate variability and new-onset hypertension: insights into pathogenesis of hypertension: the Framingham Heart Study. Hypertension 32(2):293–297

    Article  PubMed  CAS  Google Scholar 

  38. Sloan RP, McCreath H, Tracey KJ, Sidney S, Liu K, Seeman T (2007) RR interval variability is inversely related to inflammatory markers: the CARDIA study. Molecular Med (Cambridge, Mass) 13(3–4):178–184. doi:10.2119/2006-00112.Sloan

    Google Scholar 

  39. Tan ZS, Beiser AS, Fox CS, Au R, Himali JJ, Debette S, Decarli C, Vasan RS, Wolf PA, Seshadri S (2011) Association of metabolic dysregulation with volumetric brain magnetic resonance imaging and cognitive markers of subclinical brain aging in middle-aged adults: the Framingham Offspring Study. Diabetes Care 34(8):1766–1770. doi:10.2337/dc11-0308

    Article  PubMed  Google Scholar 

  40. Trollor JN, Smith E, Agars E, Kuan SA, Baune BT, Campbell L, Samaras K, Crawford J, Lux O, Kochan NA, Brodaty H, Sachdev P (2012) The association between systemic inflammation and cognitive performance in the elderly: the Sydney Memory and Ageing Study. Age 34(5):1295–1308

    Article  PubMed  CAS  Google Scholar 

  41. van den Kommer TN, Dik MG, Comijs HC, Jonker C, Deeg DJH (2012) The role of lipoproteins and inflammation in cognitive decline: Do they interact? Neurobiol Aging 33(1):196.e1–196.e12

    Article  Google Scholar 

  42. van Rossum IA, Vos S, Handels R, Visser PJ (2010) Biomarkers as predictors for conversion from mild cognitive impairment to Alzheimer-type dementia: implications for trial design. J Alzheimers Dis 20(3):881–891. doi:10.3233/jad-2010-091606

    PubMed  Google Scholar 

  43. Whelan BJ (1979) RANSAM: A random sampling design for Ireland. Econ Soc Rev 10(2):169–175

    Google Scholar 

  44. WHO Collaborating Centre for Drug Statistics Methodology (2011) Guidelines for ATC classification and DDD assignment 2012. Oslo

  45. Wolf PA (2012) Contributions of the framingham heart study to stroke and dementia epidemiologic research at 60 years. Arch Neurol 69(5):567–571. doi:10.1001/archneurol.2011.977

    Article  PubMed  Google Scholar 

  46. Zigmond AS, Snaith R (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Financial contributions from the following entities would like to be acknowledged; The Atlantic Philanthropies (research grant to the Irish Longitudinal Study of Ageing); Irish Life plc and the Irish Government (grant to the Irish Longitudinal Study of Ageing). We would also like to acknowledge the participants in the study, and the studies nurses and administrators.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. The Irish Longitudinal Study on Ageing, Lincoln Gate, Trinity College, Dublin 2, Ireland

    John Frewen, Ciaran Finucane, George M. Savva & Rose Anne Kenny

  2. Department of Medical Physics and Bioengineering, St. James’s Hospital, Dublin 8, Ireland

    Ciaran Finucane & Gerard Boyle

  3. Mercer’s Institute for Research on Ageing, St. James’s Hospital, Dublin 8, Ireland

    Robert F. Coen & Rose Anne Kenny

  4. Trinity College Institute of Neuroscience, Trinity College, Dublin 2, Ireland

    Robert F. Coen & Rose Anne Kenny

Authors
  1. John Frewen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ciaran Finucane
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George M. Savva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gerard Boyle
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert F. Coen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rose Anne Kenny
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John Frewen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Frewen, J., Finucane, C., Savva, G.M. et al. Cognitive function is associated with impaired heart rate variability in ageing adults: the Irish longitudinal study on ageing wave one results. Clin Auton Res 23, 313–323 (2013). https://doi.org/10.1007/s10286-013-0214-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10286-013-0214-x

Keywords

Search

Navigation