Heart rate response and recovery during exercise and dementia risk: a prospective UK biobank study
Yiran Wei1,2, Yonglin Shan3, Wenxiao Fan1,2
1Department of Neurology, Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P R China.
Insights
Higher heart rate response/recovery (HRR) index and recovery ratios are linked to a lower risk of dementia. These cardiovascular health indicators may also help delay cognitive decline in older adults.
Area of Science:
- Cardiology
- Neurology
- Gerontology
Background:
- The heart rate response/recovery (HRR) index is a cardiovascular health indicator during exercise.
- Previous studies linked HRR index to mortality and neurocognitive disorders.
- The association between HRR index and dementia risk was previously unknown.
Purpose of the Study:
- To investigate the relationship between the HRR index and the risk of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD).
- To examine the correlation between HRR index and cognitive decline in processing speed, reasoning, and memory.
Main Methods:
- Analysis of electrocardiogram data from 46,348 UK Biobank participants (middle-aged and older adults).
- Standardized submaximal exercise stress test (15-second baseline, 6-minute exercise, 1-minute recovery).
- Calculation of HRR index and recovery ratio; ascertainment of dementia diagnoses over a median follow-up of 12.62 years.
Main Results:
- Higher HRR index and recovery ratio were associated with a significantly reduced risk of all-cause dementia (HR: 0.72 and 0.75, respectively).
- No significant association was found between HRR index/recovery ratio and incident AD or VaD.
- Higher HRR index correlated with slower decline in processing speed, reasoning, and memory; recovery ratio correlated with slower decline in reasoning and memory.
Conclusions:
- Elevated HRR index and recovery ratio are linked to decreased dementia risk and may delay cognitive decline.
- Potential mechanisms involve autonomic function and neurovascular health.
- HRR index serves as a potential biomarker for cognitive health in aging populations.
Abstract:
The heart rate response/recovery (HRR) index, a common indicator for cardiovascular health during exercise, has been linked with neurocognitive disorders and mortality. However, the relationship between HRR index and dementia remains unknown. Electrocardiogram data from 46,348 middle-aged and older adults from the UK Biobank were analyzed following a standardized submaximal exercise stress test (15-second baseline, 6-minute exercise, and 1-minute recovery). The HRR index was calculated as the product of heart rate responses ratio during exercise (peak/resting heart rate) and recovery ratio (peak/recovery heart rate). We found that 519 participants were ascertained with dementia, including 232 with Alzheimer's disease (AD) and 85 with vascular dementia (VaD) during a median follow-up period of 12.62 years. Higher HRR index and recovery ratio were significantly associated with a reduced risk of all-cause dementia (HR: 0.72, 95% CI: 0.54-0.94, P = 0.017; HR: 0.75, 95% CI: 0.57-0.99, P = 0.018), but not with incident AD or VaD, respectively. In addition, higher HRR index was significantly correlated with slower cognitive decline in processing speed, reasoning, and memory (β:2.39, 95% CI: 0.28-4.49, P = 0.027; β: 2.12, 95% CI: 0.26-4.00, P = 0.027; β: 0.03, 95% CI: 0.02-0.05, P < 0.001), while the recovery ratio was significantly correlated with slower cognitive decline in reasoning and memory (β: 1.91, 95% CI: 0.04-3.79, P = 0.045; β: 0.03, 95% CI: 0.01-0.04, P < 0.001). Higher HRR index and recovery ratios are associated with a decreased risk of incident dementia and appear to have beneficial effects on delaying cognitive decline. The possible mechanisms for this may involve autonomic function and neurovascular health.
Related Concept Videos
01:30Factors Influencing Heart Rate
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
01:31Regulation of Heart Rates
The SNS increases heart rate through the release of norepinephrine and epinephrine, which act on beta-1 adrenergic receptors in the heart. This action increases the rate of depolarization in the sinoatrial (SA) node, the heart's...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:19Cardiac Output I:Effect of Heart Rate on Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:26Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes