title: Baroreflex sensitivity, vascular risk factors, and cognitive function in a healthy elderly population: the PROOF cohort.
abstract: OBJECTIVE
  To assess the role of the cardiac autonomic nervous system (ANS), as measured according to spontaneous cardiac baroreflex sensitivity (BRS), in the type and degree of cognitive performance in healthy young-elderly individuals, taking into account the presence of other vascular risk factors.
  
  
  METHODS
  Community-based cross-sectional study.
  
  
  METHODS
  In-home and clinical settings.
  
  
  METHODS
  A subset of participants, aged 66.9±0.9, from a prospective study that aimed to assess the influence of ANS activity on cardiovascular and cerebrovascular morbidity and mortality (N=916).
  
  
  METHODS
  All subjects underwent a clinical interview, neuropsychological testing, and autonomic and vascular measurements. Three cognitive domains were defined: attentional (Trail-Making Test Part A, Stroop code and parts I & II), executive (Trail-Making Test Part B, Stroop part III, verbal fluency and similarity tests), and memory (Benton visual retention test, Grober and Buschké procedure). Subjects were stratified according to their scores into normal, low, and impaired performers.
  
  
  RESULTS
  After adjustments to demographic and vascular data, participants with moderate autonomic dysregulation (3<BRS≤6) were determined to be 1.82 times as likely to have memory impairment (odds ratio (OR)=1.82, 95% confidence interval (CI)=1.13-3.17, P=.02) and those with severe autonomic dysregulation (BRS≤3) to be 2.65 as likely (OR=2.65, 95% CI=1.40-5.59, P=.006) as participants with normal BRS (>6).
  
  
  CONCLUSIONS
  In older individuals without dementia, autonomic dysregulation seems to have a direct, gradual, and independent effect on memory. Future studies are needed to evaluate the long-term effects of BRS and other markers of the ANS on cognitive decline.
authors.affiliation: Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France.|Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France.|Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France.|Laboratoire des Mécanismes Cognitifs, Université de Lyon 2, Lyon, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Saint Martin
authors.affiliation: Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France.|Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France.|Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France.
authors.forename: Emilia
authors.initials: E
authors.lastname: Sforza
authors.affiliation: Laboratoire des Mécanismes Cognitifs, Université de Lyon 2, Lyon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Thomas-Anterion
authors.affiliation: Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France.|Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France.|Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Barthélémy
authors.affiliation: Département de Physiologie Clinique et de l'Exercice, Pôle Neuro-OstéoLocomoteur, Centre Hospitalo-Universitaire, Saint-Étienne, France.|Faculté de Médicine de Saint-Etienne, Université Jean Moulin, Saint-Étienne, France.|Pôle de Recherche et d'Enseignement Supérieur, Université de Lyon, Lyon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Roche
mesh_terms: D000368:Aged; D017704:Baroreflex / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography
keywords: autonomic nervous system; baroreflex sensitivity; cognitive functions; healthy elderly; vascular risk factors