Can Reactivity of Heart Rate Variability Be a Potential Biomarker and Monitoring Tool to Promote Healthy Aging? A Systematic Review With Meta-Analyses

Abstract

Background: Monitoring phasic responses of heart rate variability (HRV) in terms of HRV reactivity [i. e., the absolute change from resting state to on-task (i.e., absolute values of HRV measured during exercise)] might provide useful insights into the individual psychophysiological responses of healthy middle-aged to older adults (HOA) to cognitive and physical exercises.Objectives: To summarize the evidence of phasic HRV responses to cognitive and physical exercises, and to evaluate key moderating factors influencing these responses.Methods: A systematic review with meta-analyses was performed. Publications up to May 2020 of the databases Medline (EBSCO), Embase, Cochrane Library, CINAHL, Psycinfo, Web of Science, Scopus, and Pedro were considered. Controlled clinical trials and observational studies measuring phasic HRV responses to cognitive and/or physical exercises in HOA (≥50 years) were included.Results: The initial search identified 6,828 articles, of which 43 were included into the systematic review. Compared to resting state, vagally-mediated HRV indices were significantly reduced during all types of exercises [Hedge's g = −0.608, 95 % CI (−0.999 to −0.218), p = 0.002] indicating a significant parasympathetic withdrawal compared to rest. The key moderating variables of these responses identified included exercise intensity for physical exercises, and participant characteristics (i.e., level of cognitive functioning, physical fitness), task demands (i.e., task complexity and modality) and the individual responses to these cognitive challenges for cognitive exercises. In particular, higher task demands (task complexity and physical exercise intensity) were related to larger HRV reactivities. Better physical fitness and cognition were associated with lower HRV reactivities. Additionally, HRV reactivity appeared to be sensitive to training-induced cognitive and neural changes.Conclusion: HRV reactivity seems to be a promising biomarker for monitoring internal training load and evaluating neurobiological effects of training interventions. Further research is warranted to evaluate the potential of HRV reactivity as a monitoring parameter to guide cognitive-motor training interventions and/or as a biomarker for cognitive impairment. This may facilitate the early detection of cognitive impairment as well as allow individualized training adaptations that, in turn, support the healthy aging process by optimizing individual exercise dose and progression of cognitive-motor training.

Heart rate variability: A biomarker of frailty in older adults?

“…Reduced parasympathetic activity at rest has been related to worse performance on cognitive exercises, confirming the predictions of the "neurovisceral integration" model, which suggests that HRV can regulate the functional integrity of the central nervous system (40). Higher activities of prefrontal brain structures increase HRV, while underactivity reduces HRV.…”

Making the Best Out of IT: Design and Development of Exergames for Older Adults With Mild Neurocognitive Disorder – A Methodological Paper

“…Therefore, we have conducted and are currently writing the manuscript of an experimental study with the aim to explore novel strategies for a real-time adaptive exergame system to individually tailor exergame demands according to the users’ physical and/or cognitive capabilities. More precisely, based on our findings in a recently published systematic review, the reactivity of vagally mediated heart rate variability (HRV) is evaluated as a promising monitoring parameter for internal training load that is easily measurable ( Manser et al, 2021 ). Based on the findings of this study (Manser et al, 2022c 2 ), the monitoring strategy for the final training concept was set and possible future advances for monitoring and adapting the external training load characteristics to ensure optimal internal training load were explored.…”

The Movesense Medical Sensor Chest Belt Device as Single Channel ECG for RR Interval Detection and HRV Analysis during Resting State and Incremental Exercise: A Cross-Sectional Validation Study

“…Consequently, HRV possesses a broad range of applications in health and disease. Examples include biofeedback interventions in chronic disease management [7], the assessment of cognitive function, impairment and aging [8,9], psychological states in health and disease, including posttraumatic stress disorder or psychiatric disorders such as depression or anxiety [10][11][12], pain disorders [13,14], viral infections [15,16], as a prognostic factor for cancer survival [17], endurance exercise and training prescription, and the effect of exercise and training interventions in both resting states as well as during dynamic exercise and post-exercise recovery [2,4,[18][19][20][21].…”