Autonomic dysfunction in older people

Marigold, Richard; Arias, Monica; Vassallo, Michael; Allen, Stephen; Kwan, Joseph

doi:10.1017/s0959259810000286

Cited by 11 publications

(8 citation statements)

References 102 publications

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Section: Ans Dysfunction Impaired Hrv and Risk Factors Of Ischemic mentioning

confidence: 99%

“…Aging, as a marker of stress experience, can be seen as a chronic body stressor, which leads to ANS alteration ( 122 , 123 ). Autonomic dysfunction in seniors is also attributed to several main features associated with aging, such as loss of neurons, loss of axon branches, alterations in neurotransmitters, and degenerative changes in effector organs innervated by autonomic nerves ( 122 , 123 ). Many clinical symptoms associated with aging, such as increased blood pressure and decreased baroreflex function, are associated with relatively elevated SNS and diminished PNS activities that elicit inadequate autonomic responses to physiological stressors ( 122 , 123 ).…”

Section: Ans Dysfunction Impaired Hrv and Risk Factors Of Ischemic mentioning

confidence: 99%

“…Autonomic dysfunction in seniors is also attributed to several main features associated with aging, such as loss of neurons, loss of axon branches, alterations in neurotransmitters, and degenerative changes in effector organs innervated by autonomic nerves ( 122 , 123 ). Many clinical symptoms associated with aging, such as increased blood pressure and decreased baroreflex function, are associated with relatively elevated SNS and diminished PNS activities that elicit inadequate autonomic responses to physiological stressors ( 122 , 123 ). Previous studies have shown that elderly people have significantly lower values of HF, LF, and TP powers than young people ( 124 , 125 ).…”

Section: Ans Dysfunction Impaired Hrv and Risk Factors Of Ischemic mentioning

confidence: 99%

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Autonomic Nervous System and Stress to Predict Secondary Ischemic Events after Transient Ischemic Attack or Minor Stroke: Possible Implications of Heart Rate Variability

et al. 2018

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Transient ischemic attack (TIA) and minor stroke have high risks of recurrence and deterioration into severe ischemic strokes. Risk stratification of TIA and minor stroke is essential for early effective treatment. Traditional tools have only moderate predictive value, likely due to their inclusion of the limited number of stroke risk factors. Our review follows Hans Selye’s fundamental work on stress theory and the progressive shift of the autonomic nervous system (ANS) from adaptation to disease when stress becomes chronic. We will first show that traditional risk factors and acute triggers of ischemic stroke are chronic and acute stress factors or “stressors,” respectively. Our first review shows solid evidence of the relationship between chronic stress and stroke occurrence. The stress response is tightly regulated by the ANS whose function can be assessed with heart rate variability (HRV). Our second review demonstrates that stress-related risk factors of ischemic stroke are correlated with ANS dysfunction and impaired HRV. Our conclusions support the idea that HRV parameters may represent the combined effects of all body stressors that are risk factors for ischemic stroke and, thus, may be of important predictive value for the risk of subsequent ischemic events after TIA or minor stroke.

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Section: Ans Dysfunction Impaired Hrv and Risk Factors Of Ischemic mentioning

confidence: 99%

Section: Ans Dysfunction Impaired Hrv and Risk Factors Of Ischemic mentioning

confidence: 99%

Section: Ans Dysfunction Impaired Hrv and Risk Factors Of Ischemic mentioning

confidence: 99%

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Autonomic Nervous System and Stress to Predict Secondary Ischemic Events after Transient Ischemic Attack or Minor Stroke: Possible Implications of Heart Rate Variability

et al. 2018

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“…However, because the autonomic functions of individuals decline with age, even in the absence of DLB, 5 it can be difficult to distinguish (on the basis of testimonials of subjective symptoms alone) DLB‐associated autonomic dysfunction from the subclinical autonomic dysfunction that occurs in healthy elderly individuals. Previously established clinical methods for identifying autonomic dysfunction include the Ewing battery, a detailed clinical test of autonomic functions, and the identification of orthostatic hypotension 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Heart rate response to orthostatic challenge in patients with dementia with Lewy bodies and Alzheimer's disease

et al. 2020

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Background To elucidate the differences in autonomic dysfunction between dementia with Lewy bodies (DLB) and Alzheimer's disease using a simple and convenient method, we investigated the heart rate response to orthostatic challenge. Methods Ninety‐seven people participated in this cross‐sectional study, and data from 26 DLB patients, 29 Alzheimer's disease patients, and 25 healthy elderly individuals were analysed. Participants underwent postural changes, including 5 min in a supine position, 1 min in a sitting position, and 3 min in an orthostatic position. Their heart rates were continuously recorded. Two heart rate variables were analysed as main outcomes: (i) the difference between heart rate in the sitting position and the peak heart rate within 15 s of orthostasis, defined as the ‘early heart rate increase’; and (ii) the difference between the peak heart rate and the negative peak heart rate after this, defined as ‘early heart rate recovery.’ An early heart rate increase has been considered to reflect parasympathetic and sympathetic functions. Early heart rate recovery is considered to reflect parasympathetic function. We also investigated the frequency domains of resting heart rate variability. Results A significant difference was observed across the three groups in early heart rate increase, and that of the DLB group was lower than that of the healthy control group. Early heart rate recovery also differed significantly across the three groups, and that of the DLB group was less than that of the healthy control group. In addition, the power of the low‐frequency component, which represents both sympathetic and parasympathetic activity, was significantly decreased in the DLB group compared to the Alzheimer's disease group. Conclusions Impaired heart rate response to standing was detected in patients with DLB. Electrocardiogram is a convenient, non‐invasive method that might be useful as a subsidiary marker for DLB diagnosis and differentiation from Alzheimer's disease.

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“…ANS plays a vital role in homeostasis. 1 However, with advancing age, functions of the systems may be affected and lead to autonomic dysfunction (AD). 2 AD results from overactivity or loss of regulation of autonomic circuits.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Functions of the Autonomic Nervous System in the Elderly with Different Comorbid Factors

Sushma

Rao

Shaikh

2020

JNRP

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Background Studies in healthy elderly patients have shown the prevalence of autonomic dysfunction (AD) in the range of 20 to 30%. However, there is paucity in data pertaining to AD in the elderly in the Indian context. Objective To assess the prevalence of AD in the elderly irrespective of their comorbidity status. Methods A total of 141 elderly patients with or without comorbidities/symptoms of AD were included. Demographic and clinical details of the patients were recorded. Autonomic function tests (AFTs) such as deep breathing test, Valsalva ratio, orthostatic heart rate (OHR), isometric handgrip test, and orthostatic blood pressure were performed based on Ewing’s battery of tests. The sensitivity, specificity, positive predictive value, negative predictive value, and the accuracy of AFTs were evaluated. Results Most patients (n = 85) were aged between 60 and 69 years, with a male predominance (58.87%). Hypertension and diabetes mellitus were the most common comorbidities. Postural hypotension was the most common symptom of AD. With advancing age, symptoms of AD manifested significantly more. Overall, 73.8% of patients had AD, of whom 45.4% had early AD. Number of AD symptoms, glycated hemoglobin (HbA1c) level, and comorbid factors (diabetes and hypertension) were significantly associated with the results of AFTs (p < 0.05). AFTs were highly significant with respect to the results obtained (p < 0.001). Deep breathing test, abnormal in majority of study patients, has a sensitivity of 93.3% and OHR has a specificity of 81.1% to determine AD. Conclusion The study concludes that age itself is an independent predictor of AD, which increases in severity if associated with comorbidities.

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Autonomic dysfunction in older people

Cited by 11 publications

References 102 publications

Autonomic Nervous System and Stress to Predict Secondary Ischemic Events after Transient Ischemic Attack or Minor Stroke: Possible Implications of Heart Rate Variability

Autonomic Nervous System and Stress to Predict Secondary Ischemic Events after Transient Ischemic Attack or Minor Stroke: Possible Implications of Heart Rate Variability

Heart rate response to orthostatic challenge in patients with dementia with Lewy bodies and Alzheimer's disease

Assessment of Functions of the Autonomic Nervous System in the Elderly with Different Comorbid Factors

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