Abstract
BackgroundObesity can limit physical capacity and lower physical activity levels in elderly people. Low physical activity levels may be mediated by autonomic dysfunction with decreased heart rate variability (HRV). However, the relationship between autonomic dysfunction and low physical capability remains unclear. This cross-sectional study investigated the association of low physical capability with HRV in older adults with obesity.Materials and methodsWe recruited 231 old man and 210 old women with a mean (range) age of 65.5 (51−78) and 62.9 (52−76) years, respectively. Physical capability was measured using mobility tasks, including functional reach, single-leg stance (SLS), gait speed (GS), timed up and go, and timed chair rise (TCR), and the scores on these tasks were merged and transformed into a global physical capability score (GPCS). HRV was measured using a 7-min resting pulse-based technique, and the time- and frequency-domain indices of HRV were obtained including standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences at rest (rMSSD), and high-frequency (HF) power. All HRV indices were natural log (ln) transformed for analysis. Participants were divided into high, moderate, and low physical-capability groups according to their physical performance. Multivariate analysis of covariance was performed to test differences in HRV indices among physical-capability groups with participants’ characteristics serving as covariates. A stepwise regression model was established to identify the determinants of HRV indices. We used hierarchical regression analysis to identify the association of the GPCS with HRV indices.ResultsIn both men and women, the low physical-capability group exhibited significantly increased heart rate (P <0.05) and decreased HRV in terms of a decreased ln[SDNN] (P <0.001), ln[rMSSD] (P <0.05) and ln[HF] (P <0.05), compared with the high physical-capability group. GS positively predicted ln[SDNN], whereas SLS, GS, and TCR were determinants of ln[HF], regardless of gender. The GPCS in older men and women independently accounted for 29.9% (P <0.001) and 23.7% (P <0.001), respectively, in variance in ln[SDNN].ConclusionsA low physical-capability level is an independent determinant of decreased HRV in older adults with obesity.
Highlights
Obesity is a burden on the elderly population, and it contributes to an increased risk of many medical problems, such as diabetes mellitus and cardiometabolic disease, that eventually have a substantial negative impact on an individual’s health status [1,2,3]
The global physical capability score (GPCS) in older men and women independently accounted for 29.9% (P
A low physical-capability level is an independent determinant of decreased heart rate variability (HRV) in older adults with obesity
Summary
Obesity is a burden on the elderly population, and it contributes to an increased risk of many medical problems, such as diabetes mellitus and cardiometabolic disease, that eventually have a substantial negative impact on an individual’s health status [1,2,3]. Obesity is characterized by a proinflammatory state initiated by adipocytes, and the adiposity-engendered systemic inflammation is closely linked to metabolic risk factors such as hyperinsulinemia and hyperglycemia [3, 4]. These risk factors further impair body homeostasis through a series of hemodynamic consequences [2, 4]. Low physical activity levels may be mediated by autonomic dysfunction with decreased heart rate variability (HRV). The relationship between autonomic dysfunction and low physical capability remains unclear This cross-sectional study investigated the association of low physical capability with HRV in older adults with obesity
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