Cargando…

Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study

Agitation in Alzheimer’s disease is common and may be related to impaired emotion regulation capacity. Heart rate variability, a proposed index of autonomic and emotion regulation neural network integrity, could be associated with agitation propensity in Alzheimer’s disease. We used the Atherosclero...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Kathy Y, Whitsel, Eric A, Heiss, Gerardo, Palta, Priya, Reeves, Suzanne, Lin, Feng V, Mather, Mara, Roiser, Jonathan P, Howard, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631859/
https://www.ncbi.nlm.nih.gov/pubmed/37946792
http://dx.doi.org/10.1093/braincomms/fcad269
_version_ 1785132449546633216
author Liu, Kathy Y
Whitsel, Eric A
Heiss, Gerardo
Palta, Priya
Reeves, Suzanne
Lin, Feng V
Mather, Mara
Roiser, Jonathan P
Howard, Robert
author_facet Liu, Kathy Y
Whitsel, Eric A
Heiss, Gerardo
Palta, Priya
Reeves, Suzanne
Lin, Feng V
Mather, Mara
Roiser, Jonathan P
Howard, Robert
author_sort Liu, Kathy Y
collection PubMed
description Agitation in Alzheimer’s disease is common and may be related to impaired emotion regulation capacity. Heart rate variability, a proposed index of autonomic and emotion regulation neural network integrity, could be associated with agitation propensity in Alzheimer’s disease. We used the Atherosclerosis Risk in Communities Study cohort data, collected over seven visits spanning over two decades, to investigate whether heart rate variability (change) was associated with agitation risk in individuals clinically diagnosed with dementia due to Alzheimer’s disease. Agitation (absence/presence) at Visit 5, the primary outcome, was based on the Neuropsychiatric Inventory agitation/aggression subscale, or a composite score comprising the total number of agitation/aggression, irritability, disinhibition and aberrant motor behaviour subscales present. Visit 1–5 heart rate variability measures were the log-transformed root mean square of successive differences in R–R intervals and standard deviation of normal-to-normal R–R intervals obtained from resting, supine, standard 12-lead ECGs. To aid interpretability, heart rate variability data were scaled such that model outputs were expressed for each 0.05 log-unit change in heart rate variability (which approximated to the observed difference in heart rate variability with every 5 years of age). Among 456 participants who had dementia, 120 were clinically classified to have dementia solely attributable to Alzheimer’s disease. This group showed a positive relationship between heart rate variability and agitation risk in regression models, which was strongest for measures of (potentially vagally mediated) heart rate variability change over the preceding two decades. Here, a 0.05 log-unit of heart rate variability change was associated with an up to 10-fold increase in the odds of agitation and around a half-unit increase in the composite agitation score. Associations persisted after controlling for participants’ cognitive status, heart rate (change), sociodemographic factors, co-morbidities and medications with autonomic effects. Further confirmatory studies, incorporating measures of emotion regulation, are needed to support heart rate variability indices as potential agitation propensity markers in Alzheimer’s disease and to explore underlying mechanisms as targets for treatment development.
format Online
Article
Text
id pubmed-10631859
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-106318592023-11-09 Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study Liu, Kathy Y Whitsel, Eric A Heiss, Gerardo Palta, Priya Reeves, Suzanne Lin, Feng V Mather, Mara Roiser, Jonathan P Howard, Robert Brain Commun Original Article Agitation in Alzheimer’s disease is common and may be related to impaired emotion regulation capacity. Heart rate variability, a proposed index of autonomic and emotion regulation neural network integrity, could be associated with agitation propensity in Alzheimer’s disease. We used the Atherosclerosis Risk in Communities Study cohort data, collected over seven visits spanning over two decades, to investigate whether heart rate variability (change) was associated with agitation risk in individuals clinically diagnosed with dementia due to Alzheimer’s disease. Agitation (absence/presence) at Visit 5, the primary outcome, was based on the Neuropsychiatric Inventory agitation/aggression subscale, or a composite score comprising the total number of agitation/aggression, irritability, disinhibition and aberrant motor behaviour subscales present. Visit 1–5 heart rate variability measures were the log-transformed root mean square of successive differences in R–R intervals and standard deviation of normal-to-normal R–R intervals obtained from resting, supine, standard 12-lead ECGs. To aid interpretability, heart rate variability data were scaled such that model outputs were expressed for each 0.05 log-unit change in heart rate variability (which approximated to the observed difference in heart rate variability with every 5 years of age). Among 456 participants who had dementia, 120 were clinically classified to have dementia solely attributable to Alzheimer’s disease. This group showed a positive relationship between heart rate variability and agitation risk in regression models, which was strongest for measures of (potentially vagally mediated) heart rate variability change over the preceding two decades. Here, a 0.05 log-unit of heart rate variability change was associated with an up to 10-fold increase in the odds of agitation and around a half-unit increase in the composite agitation score. Associations persisted after controlling for participants’ cognitive status, heart rate (change), sociodemographic factors, co-morbidities and medications with autonomic effects. Further confirmatory studies, incorporating measures of emotion regulation, are needed to support heart rate variability indices as potential agitation propensity markers in Alzheimer’s disease and to explore underlying mechanisms as targets for treatment development. Oxford University Press 2023-10-13 /pmc/articles/PMC10631859/ /pubmed/37946792 http://dx.doi.org/10.1093/braincomms/fcad269 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Liu, Kathy Y
Whitsel, Eric A
Heiss, Gerardo
Palta, Priya
Reeves, Suzanne
Lin, Feng V
Mather, Mara
Roiser, Jonathan P
Howard, Robert
Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study
title Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study
title_full Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study
title_fullStr Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study
title_full_unstemmed Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study
title_short Heart rate variability and risk of agitation in Alzheimer’s disease: the Atherosclerosis Risk in Communities Study
title_sort heart rate variability and risk of agitation in alzheimer’s disease: the atherosclerosis risk in communities study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631859/
https://www.ncbi.nlm.nih.gov/pubmed/37946792
http://dx.doi.org/10.1093/braincomms/fcad269
work_keys_str_mv AT liukathyy heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT whitselerica heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT heissgerardo heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT paltapriya heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT reevessuzanne heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT linfengv heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT mathermara heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT roiserjonathanp heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy
AT howardrobert heartratevariabilityandriskofagitationinalzheimersdiseasetheatherosclerosisriskincommunitiesstudy