Heart Rate Linked to Functional Decline in Older Patients

New research finds that a higher resting heart rate and lower variability in heart rate are connected to functional decline in older patients. 

For their study, investigators obtained data from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). In total, 5,042 participants, with a mean age of 75.3 years, were included in the study, with a mean follow-up of 3.2 years. Patients completed questionnaires assessing basic activities of daily living, such as toilet use, and instrumental activities of daily living, such as phone use, at baseline and again just after the 3-year mark.
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Heart rate and heart rate variability were derived from baseline 10-second electrocardiograms, according to the authors, who note that heart rate variability was defined as the standard deviation of normal-to-normal RR intervals. Functional status in basic and instrumental activities of living was measured using Barthel and Lawton sales, at baseline and during follow-up.

The researchers found that higher resting heart rate and lower heart rate variability at baseline was linked to a decline in activities of daily living from baseline to follow-up. Participants with heart rates in the highest tertile, for instance, were roughly 80% more likely to experience decline in basic daily living activities at 3 years, compared to those with heart rates in the lowest tertile.

The findings indicate that “simple physiologic markers such as heart or heart variability can be used in identification of older subjects at risk for functional decline,” says Behnam Sabayan, MD, PhD, a postdoctoral research fellow at Leiden University Medical Center in the Netherlands, and co-author of the study.

The study was performed in a population of older subjects with relatively good functional status at baseline, meaning that “primary care physicians could be more proactive in the risk assessment of older subjects,” says Sabayan, noting that the measures the authors used are obtained from 10-sec ECG, “which is routinely obtained in the clinical practice.”

Changes in heart rate “can be an early manifestation not only for autonomic abnormalities,” continues Sabayan, “but also for general physical well-being of older adults.

—Mark McGraw

Reference

Ogliari G, Mahinrad S, et al. Resting heart rate, heart rate variability and functional decline in old age. CMAJ. 2015.