| Objective:To investigate the correlation between heart rate variability(HRV)and cognitive frailty in patients with cerebral small vessel disease(CSVD)in the elder ly.Methods:This study included 191 hospitalized elder ly patients with cerebral small vessel disease(CSVD)who were admitted to the Departments of Geriatrics,Neurology and Cardiovascular Medicine at the F irst Affiliated Hospital of Shihezi University between November 2021 and December 2022,and who were aged 65 years or older and completed both cranial magnetic resonance imaging and 24-hour dynamic electrocardiogram.General information,laboratory indexes and HRV indexes of elderly CSVD patients were collected,and their cognitive frailty status was assessed using the Montreal Cognitive Assessment Scale(MoCA)and the FRAIL Scale.The correlation between HRV and cognitive frailty in elder ly CSVD patients was statistically analyzed.Results:1.Correlation analysis between HRV and cognitive frailty:Elder ly CSVD patients were divided into the non-cognitive frailty group(160 cases)and the cognitive frailty group(31 cases)based on the MoCA and FRAIL scores.(1)There were signif icant differences between the cognitive frailty group and the non-cognitive frailty group in terms of age,education level,high-density lipoprotein cholesterol(HDL-C),and D-dimer(P<0.05).(2)The cognitive frailty group had lower values of standard deviation of all normal to normal RR intervals(SDNN),mean of the standard deviation of all normal to normal RR intervals for all 5-min segment of 24 hours(SDNNindex),root mean square of successive RR interval differences(rMSSD),percentage of NN50 in the total number of NN intervals(PNN50),low frequency power(LF),and high frequency power(HF)compared to the group without cognitive frailty(P<0.05).(3)Age,education level,and SDNN(OR=0.943,95%CI:0.904-0.984;P=0.007)were identified as influencing factors for cognitive frailty in elder ly CSVD patients.2.Further analysis of the correlation between HRV and cognitive impairment:Elder ly CSVD patients were divided into the non-cognitive impairment group(107 cases)and the cognitive impairment group(84cases)based on the MoCA score.(1)The age of the Cognitive impairment group was higher than that of the group without Cognitive impairment(P<0.05);(2)The Cognitive impairment group had lower SDNN,SDNN index,rMSSD,PNN50,and LF values compared to the group without Cognitive impairment(P<0.05).(3)In elderly CSVD patients,MoCA scores were positively correlated w ith SDNN(r_s=0.556,P<0.001),SDNN index(r_s=0.435,P<0.001),PNN50(r_s=0.271,P=0.001),and LF(r_s=0.383,P<0.001);(4)SDNN(OR=0.968,95%CI:0.944-0.993;P=0.013)and SDNN index(OR=0.930,95%CI:0.877-0.987;P=0.016)were influencing factors for Cognitive impairment in elder ly CSVD patients.3.Further analysis of the correlation between HRV and frailty:Elder ly CSVD patients were divided into a non-frailty group(n=138)and a frailty group(n=53)based on FRAIL scores.(1)There were differences between the frailty and non-frailty groups in terms of age,diastolic blood pressure,education level,and white blood cell count(WBC)(P<0.05).(2)The frailty group had significantly lower values of SDNN,SDNN index,PNN50,and LF compared to the non-frailty group(P<0.05);(3)In elderly CSVD patients,FRAIL scores were negatively correlated with SDNN(r_s=-0.483,P<0.001),SDNN index(r_s=-0.278,P<0.001),PNN50(r_s=-0.168,P=0.026),and LF(r_s=-0.203,P=0.007).(4)Age,education level,and SDNN(OR=0.939,95%CI:0.908-0.972;P<0.001)were influencing factors for frailty in elder ly CSVD patients.Conclusion:1.HRV reduction is an influencing factor of cognitive frailty in older patients with CSVD,suggesting that HRV reduction may be involved in the development of cognitive frailty in older patients with CSVD;2.HRV reduction is associated with the occurrence of cognitive impairment and frailty in older patients with CSVD,indicating that HRV reduction may be a common risk factor for cognitive impairment and frailty in older patients with CSVD. |
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