Resting Heart Rate and Cognitive Decline: A Meta-Analysis of Prospective Cohort Studies

Abstract

Background and Purpose Several previous meta-analyses have identified an association between cognitive decline and heart rate variability, which reflects autonomic nerve activity. This systematic review and meta-analysis investigated the impact of increased resting heart rate (RHR) on the incidence of cognitive decline, including dementia. Methods The PubMed, Embase, and PsycInfo databases were searched for relevant prospective cohort studies published before April 18, 2022. A methodological quality assessment of the included studies was conducted using the Newcastle–Ottawa Scale. Summary estimates of the incidence of cognitive decline, including dementia, were generated using a random-effects model. Potential publication bias was evaluated using Begg’s funnel plots and Egger’s regression tests. Results The meta-analysis included 7 prospective cohort studies comprising 53,621 participants. A weak significant association was observed between RHR and the risk of cognitive decline, although the analysis indicated high heterogeneity among the studies (relative risk=1.18, 95% confidence interval=1.04–1.33, I 2 =82.5%). Significant associations were determined between RHR and all combined types of dementia except for Alzheimer’s disease and mild cognitive impairment. There was also a dose–response association between increased RHR and cognitive decline. The meta-estimate of the cognitive decline risk associated with a 10 beat-per-minute increase in RHR was 1.06, and it was 1.10 for dementia. Conclusions This study found that a higher RHR was associated with an increased cognitive decline risk. Due to study limitations such as publication bias and high heterogeneity, additional studies are required to validate this finding. Systematic review registration PROSPERO registration number CRD42021282912.

Cardiac Autonomic Activity, Personality Traits, and Academic Performance in First-Year Medical Students: A Gender-Specific Relation

“…Contrary to our assumptions, we found no relation between resting heart rate and academic performance. This finding does not support studies that report greater cognitive decline in those with higher resting heart rates [12,13].…”

“…Given that stress activates the sympathetic nervous system, while the parasympathetic system dominates in conditions of rest and concord [11], we hypothesized that lower resting heart rates would be associated with calmer demeanors and therefore with higher academic outcomes. Further, evidence suggests that higher resting heart rates are associated with greater cognitive decline, as reported in middle-aged individuals [12] and as concluded by a recent meta-analysis [13]. These reports suggest the relation of resting heart rate to cognition and support our hypothesis.…”