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Baroreflex Sensitivity, Vascular Risk Factors, and Cognitive Function in a Healthy Elderly Population: The PROOF Cohort
Author(s) -
Saint Martin Magali,
Sforza Emilia,
ThomasAnterion Catherine,
Barthélémy Jean Claude,
Roche Frédéric
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12548
Subject(s) - medicine , stroop effect , baroreflex , population , confidence interval , trail making test , cognition , cardiology , odds ratio , neuropsychology , cohort , prospective cohort study , heart rate , blood pressure , psychiatry , environmental health
Objectives To assess the role of the cardiac autonomic nervous system ( ANS ), as measured according to spontaneous cardiac baroreflex sensitivity ( BRS ), in the type and degree of cognitive performance in healthy young‐elderly individuals, taking into account the presence of other vascular risk factors. Design Community‐based cross‐sectional study. Setting In‐home and clinical settings. Participants A subset of participants, aged 66.9 ± 0.9, from a prospective study that aimed to assess the influence of ANS activity on cardiovascular and cerebrovascular morbidity and mortality (N = 916). Measurements All subjects underwent a clinical interview, neuropsychological testing, and autonomic and vascular measurements. Three cognitive domains were defined: attentional ( T rail‐ M aking T est P art A, S troop code and parts I & II ), executive ( T rail‐ M aking T est P art B , Stroop part III , verbal fluency and similarity tests), and memory (Benton visual retention test, Grober and Buschké procedure). Subjects were stratified according to their scores into normal, low, and impaired performers. Results After adjustments to demographic and vascular data, participants with moderate autonomic dysregulation (3 < BRS ≤ 6) were determined to be 1.82 times as likely to have memory impairment (odds ratio ( OR ) = 1.82, 95% confidence interval ( CI ) = 1.13–3.17, P = .02) and those with severe autonomic dysregulation ( BRS ≤ 3) to be 2.65 as likely ( OR = 2.65, 95% CI = 1.40–5.59, P = .006) as participants with normal BRS (>6). Conclusion In older individuals without dementia, autonomic dysregulation seems to have a direct, gradual, and independent effect on memory. Future studies are needed to evaluate the long‐term effects of BRS and other markers of the ANS on cognitive decline.