Cardio‐autonomic control and cognitive decline in older adults
Bibliographic record
Abstract
Abstract Background Cardiovascular diseases may be linked to dementia pathogenesis. The cardio‐autonomic control (CAC) plays an important role in the development of cardiovascular diseases and may be implicated by dementia pathophysiology. We tested whether the CAC proxied by the complexity of beat‐to‐beat pulse rate intervals (PRI) predicted longitudinal cognitive decline in older adults. Method Continuous overnight pulse oximetry (photoplethysmography) data from 594 participants (mean age = 82.76±7.11 at oximetry assessment; 76% female) in the Rush Memory and Aging projects were studied. All participants completed cognitive assessments at oximetry baseline. Eighty‐four participants who had at least one follow‐up cognitive assessment were included in the analyses. After quality control, the feet of pulse waves in the photoplethysmography data were detected, and the consecutive foot‐to‐foot internals (i.e., PRI) time‐series within each 10‐min window were analyzed using the distribution entropy that evaluated the complexity of PRI (i.e., greater distribution entropy means more complex dynamics). To reduce behavioral and circadian effects, we used the mean distribution entropy values during 12AM‐3AM for each individual. Mixed‐effects models were constructed to associate distribution entropy to longitudinal cognitive changes, adjusting for age, sex, and education. Result At baseline, distribution entropy was normally distributed (mean = 0.33±0.14). On average, the global cognition score was 0.12 units (SD = 0.60). This score declined at an annual rate of 0.15 units (SE = 0.04; p = 0.0001). The distribution entropy was not associated with global cognition at baseline, but greater distribution entropy predicted slower cognitive decline. Specifically, a 1‐SD increase in distribution entropy correlated with a drop of 0.11 (SE = 0.04; p = 0.005) in the rate of cognitive decline. Conclusion The nighttime CAC (potentially during sleep) is linked with longitudinal cognitive profiles in older adults. As the CAC is regulated by an internal body clock—the circadian system, in which a dysfunction is involved in Alzheimer’s pathogenesis, it is possible that the CAC underlies the connections of cardiovascular disorders and circadian dysfunction with Alzheimer’s disease and its clinical outcomes. Future studies are warranted to test these hypotheses. Further studies should also investigate whether CAC at different times of the night has different correlations with cognitive changes and whether CAC predicts Alzheimer’s disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".