Baroreflex Sensitivity, Vascular Risk Factors, and Cognitive Function in a Healthy Elderly Population: The PROOF Cohort

Authors

  • Magali Saint Martin MS,

    Corresponding author
    1. Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France
    2. Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France
    3. Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France
    4. Laboratoire des Mécanismes Cognitifs, Université de Lyon 2, Lyon, France
    • Address correspondence to Magali Saint Martin, Département de physiologie Clinique, EFCR, CHU Nord—Niveau 6—F—42055 Saint-Étienne Cedex 2, France. E-mail: magali.stmartin@orange.fr

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  • Emilia Sforza MD, PhD,

    1. Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France
    2. Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France
    3. Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France
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  • Catherine Thomas-Anterion MD,

    1. Laboratoire des Mécanismes Cognitifs, Université de Lyon 2, Lyon, France
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  • Jean Claude Barthélémy MD, PhD,

    1. Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France
    2. Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France
    3. Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France
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  • Frédéric Roche MD, PhD,

    1. Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France
    2. Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France
    3. Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France
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  • and on behalf of The PROOF Study Group


Abstract

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 (Trail-Making Test Part A, Stroop code and parts I & II), executive (Trail-Making Test Part 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.

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