Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France.
Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France.
J Am Geriatr Soc. 2013 Dec;61(12):2096-2102. doi: 10.1111/jgs.12548. Epub 2013 Nov 26.
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.
Community-based cross-sectional study.
In-home and clinical settings.
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).
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.
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).
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.
评估心脏自主神经系统（ANS）的作用，根据自主心脏压力反射敏感性（BRS）来衡量，在健康的年轻老年人中，考虑到其他血管危险因素的存在，对认知表现的类型和程度的作用。
基于社区的横断面研究。
家庭和临床环境。
来自一项旨在评估 ANS 活性对心血管和脑血管发病率和死亡率影响的前瞻性研究的参与者的一个亚组，年龄 66.9±0.9（N=916）。
所有受试者均接受临床访谈、神经心理学测试以及自主和血管测量。定义了三个认知领域：注意力（Trail-Making Test 部分 A、Stroop 码和部分 I & II）、执行（Trail-Making Test 部分 B、Stroop 部分 III、言语流畅性和相似性测试）和记忆（Benton 视觉保留测试、Grober 和 Buschké 程序）。根据他们的分数将受试者分为正常、低和受损的表现者。
在调整人口统计学和血管数据后，确定中度自主神经调节障碍（3<BRS≤6）的参与者发生记忆障碍的可能性是正常 BRS（>6）的参与者的 1.82 倍（比值比（OR）=1.82，95%置信区间（CI）=1.13-3.17，P=.02），严重自主神经调节障碍（BRS≤3）的参与者发生记忆障碍的可能性是正常 BRS（>6）的参与者的 2.65 倍（OR=2.65，95% CI=1.40-5.59，P=.006）。
在没有痴呆的老年人群中，自主神经调节似乎对记忆有直接、渐进和独立的影响。需要进一步研究来评估 BRS 和其他自主神经系统标志物对认知能力下降的长期影响。
