Association of resting heart rate with cognitive decline and brain age in older adults: a large‐scale cohort study in the UK Biobank

Abstract

AbstractBackgroundThe relationship of resting heart rate (RHR), a common indicator of cardiovascular health, with cognitive decline is unclear. We aimed to investigate the association of RHR with cognitive trajectory and brain age assessed by brain Magnetic Resonance Imaging (MRI) in the UK Biobank.MethodWithin the UK Biobank 18,210 chronic brain disorders‐free participants aged 60+ were followed for up to 16 years. RHR was assessed by blood pressure monitor and categorized into <60, 60‐69 (reference), 70‐79, and ≥80 beats per minute (bpm). Cognitive function including global cognition, numeric memory, prospective memory, pairs matching, fluid intelligence, and reaction time was collected at baseline and each follow‐up wave. A subsample of 10,458 participants underwent brain MRI (T1‐weighted MRI, T2‐FLAIR, T2∗, diffusion‐MRI, task fMRI, and resting‐state fMRI) to detect brain age and brain predicted age difference (PAD) using Lasso regression. Data were analyzed using mixed‐effects model and linear regression model.ResultCompared to reference group, RHR≥80 bpm was associated with faster decline in global cognition (β: ‐0.03, 95% confidence interval [CI]: ‐0.05, ‐0.01) and reaction time (β: ‐0.03, 95% CI: ‐0.07, ‐0.01). In the MRI data analysis, RHR≥80 bpm was associated with older brain age (β [95% CI]: 0.50 [0.25, 0.76]) and bigger brain PAD (β [95% CI]: 0.50 [0.26, 0.74]).ConclusionHigher RHR is associated with faster cognitive decline and older brain age. Monitoring and controlling elevated RHR could be a promising interventional target in preserving cognitive function.