Psychological status and physical performance are independently associated with autonomic function
Document Type
Article
Publication Date
5-1-2022
Abstract
Background Falls among older adults have become a global concern. While previous studies have established associations between autonomic function indicator; heart rate variability (HRV) and blood pressure variability (BPV) with fall recurrence, as well as physical inactivity and psychological disorders as risk factors for falls, the influence of physical activity and psychological status on autonomic dysfunction observed among older fallers has not been adequately investigated. The aim of this study was to evaluate the relationship between psychological disorder and physical performance on the autonomic nervous system (ANS) in older fallers. We hypothesised that older fallers have poorer autonomic function, greater dependency on others and were associated with psychological disorders. Furthermore, we hypothesised that both physical performance and psychological status can contribute to the worsening of the autonomic function among the elderly. Methods In this cross-sectional survey, adults aged >= 60 years were recruited. Continuous non-invasive BP was monitored over 5 min of supine and 3 min of standing. Psychological status was assessed in terms of depression, anxiety, stress, and concern about falling, while functional status was measured using time-up-and-go, functional reach, handgrip and Lawton's Instrumental Activities of Daily Life (IADL) scale. Results A total of 62 participants were recruited consisting of 37 fallers and 25 non-fallers. Multivariate analysis revealed that Lawton IADL was independently associated with systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV) during both supine (SBPV: r(2) = 0.080, p = 0.025; DBPV: r(2) = 0.064, p = 0.046) and standing (SBPV: r(2) = 0.112, p = 0.008; DBPV: r(2) = 0.105, p = 0.011), while anxiety score was independently associated with SBPV and DBPV during standing (SBPV: r(2) = 0.112, p = 0.009; DBPV: r(2) = 0.105, p = 0.011) as compared to the other parameters. Conclusion Our findings suggest that fallers had poorer ANS, greater dependence in IADLs, and were more anxious. IADL dependency and anxiety were the most predictive of autonomic dysfunction, and can be used in practice to identify poor autonomic function for the prevention of falls and cardiovascular diseases among older adults.
Keywords
Fall, Autonomic nervous system, Psychological disorder, Physical performance
Divisions
biomedengine,fac_med
Funders
University of Malaya Health and Wellbeing Cluster Impactful Interdisciplinary Research
Publication Title
BioMedical Engineering OnLine
Volume
21
Issue
1
Publisher
BMC
Publisher Location
CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND