Abstract
Background: Monitoring phasic responses of heart rate variability (HRV) in terms of HRV reactivity [i. e., the absolute change from resting state to on-task (i.e., absolute values of HRV measured during exercise)] might provide useful insights into the individual psychophysiological responses of healthy middle-aged to older adults (HOA) to cognitive and physical exercises.Objectives: To summarize the evidence of phasic HRV responses to cognitive and physical exercises, and to evaluate key moderating factors influencing these responses.Methods: A systematic review with meta-analyses was performed. Publications up to May 2020 of the databases Medline (EBSCO), Embase, Cochrane Library, CINAHL, Psycinfo, Web of Science, Scopus, and Pedro were considered. Controlled clinical trials and observational studies measuring phasic HRV responses to cognitive and/or physical exercises in HOA (≥50 years) were included.Results: The initial search identified 6,828 articles, of which 43 were included into the systematic review. Compared to resting state, vagally-mediated HRV indices were significantly reduced during all types of exercises [Hedge's g = −0.608, 95 % CI (−0.999 to −0.218), p = 0.002] indicating a significant parasympathetic withdrawal compared to rest. The key moderating variables of these responses identified included exercise intensity for physical exercises, and participant characteristics (i.e., level of cognitive functioning, physical fitness), task demands (i.e., task complexity and modality) and the individual responses to these cognitive challenges for cognitive exercises. In particular, higher task demands (task complexity and physical exercise intensity) were related to larger HRV reactivities. Better physical fitness and cognition were associated with lower HRV reactivities. Additionally, HRV reactivity appeared to be sensitive to training-induced cognitive and neural changes.Conclusion: HRV reactivity seems to be a promising biomarker for monitoring internal training load and evaluating neurobiological effects of training interventions. Further research is warranted to evaluate the potential of HRV reactivity as a monitoring parameter to guide cognitive-motor training interventions and/or as a biomarker for cognitive impairment. This may facilitate the early detection of cognitive impairment as well as allow individualized training adaptations that, in turn, support the healthy aging process by optimizing individual exercise dose and progression of cognitive-motor training.
Highlights
RationaleMaintaining good cognitive and physical functioning plays a fundamental role in healthy aging and well-being (Yam and Marsiske, 2013; Organization, 2015; Reuter-Lorenz et al, 2016; Zanjari et al, 2017)
The results suggest three main findings: First, vagally-mediated heart rate variability (HRV) indices are reduced during exercise indicating a significant parasympathetic withdrawal compared to resting state
This systematic review with meta-analyses showed that vagallymediated HRV is significantly reduced during cognitive and/or physical exercises compared to resting state, indicating a significant parasympathetic withdrawal compared to rest
Summary
RationaleMaintaining good cognitive and physical functioning plays a fundamental role in healthy aging and well-being (Yam and Marsiske, 2013; Organization, 2015; Reuter-Lorenz et al, 2016; Zanjari et al, 2017). The normal aging process is associated with structural and functional changes in the brain that are associated with a gradual decline in physical and cognitive abilities, possibly limiting functional abilities of daily life and quality of life (Harada et al, 2013; Bennett and Madden, 2014; Lockhart and DeCarli, 2014; Dumas, 2015; Murman, 2015; Organization, 2015; Cleeland et al, 2019; Salthouse, 2019) This functional decline exists on a continuum from healthy aging to pathological states like “mild cognitive impairment” or “dementia” (Petersen et al, 1997, 2014; Lindbergh et al, 2016; Sanford, 2017; Janelidze and Botchorishvili, 2018). Monitoring phasic responses of heart rate variability (HRV) in terms of HRV reactivity [i. e., the absolute change from resting state to on-task (i.e., absolute values of HRV measured during exercise)] might provide useful insights into the individual psychophysiological responses of healthy middle-aged to older adults (HOA) to cognitive and physical exercises
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