Reduced Heart Rate Recovery Is Associated with Poorer Cognitive Function in Older Adults with Cardiovascular Disease

Therese A Keary,Joel Hughes,John Gunstad,James Rosneck,Donna Waechter,Mary Beth Spitznagel,Richard Josephson,Rachel Galioto

doi:10.1155/2012/392490

Abstract

Cardiovascular disease (CVD) in older adults has been associated with varying degrees of cognitive dysfunction. Several mechanisms may explain this association, including impaired cardiovascular reactivity to autonomic nervous system (ANS) signaling. Reduced heart rate recovery following a stress test may be considered an indication of impaired ANS function (i.e., reduced parasympathetic activity). Participants were 47 older adults (53–83 years) who underwent a treadmill stress test and were administered a comprehensive neuropsychological battery upon entry to phase II cardiac rehabilitation. Reduced parasympathetic activity was associated with impaired cognitive performance on a measure of global cognitive function and on tasks of speeded executive function and confrontation naming. These relationships suggest that changes in autonomic function may be mechanistically related to the impaired cognitive function prevalent in CVD patients.

Highlights

Cardiovascular disease (CVD) is associated with varying degrees of cognitive impairment, ranging from minimal difficulties (“brain at risk stage”) to dementia [1,2,3,4] and is associated with cognitive decline above and beyond the normal aging process [5]
The results of the present study indicate that greater heart rate recovery two minutes after exercise termination is associated with better performance in multiple cognitive domains, including global cognitive function, speeded executive function, and language
Endothelial dysfunction and impaired cardiovascular reactivity to autonomic nervous system (ANS) signaling are common in CVD patients [39,40,41,42,43,44] and have been suggested as a contributor to cognitive dysfunction in other studies [45]

Summary

Introduction

Cardiovascular disease (CVD) is associated with varying degrees of cognitive impairment, ranging from minimal difficulties (“brain at risk stage”) to dementia [1,2,3,4] and is associated with cognitive decline above and beyond the normal aging process [5]. Impaired cognitive function is observed in persons with CVD, even in the absence of major cardiac events [6]. Older adults with CVD frequently report experiencing significant cognitive dysfunction in everyday life and men with CVD demonstrate a reduction in cognitive function equivalent to approximately four to five years of additional age [7, 8]. These findings are in addition to the known associated between CVD and severe neurological conditions like stroke and Alzheimer’s disease [9, 10]. Recent work implicates disrupted autonomic nervous system (ANS) signaling as another potential mechanism for the cognitive impairment, as both blood pressure variability (e.g., standard deviation of systolic blood pressure) and heart rate variability have been linked to neurocognitive outcome in persons with CVD [17,18,19]

Methods

Results

Conclusion