Assessment of heart rate deceleration capacity, heart rate deceleration runs, heart rate acceleration capacity, and lipoprotein-related phospholipase A2 as predictors in individuals with dementia

Background: Autonomic dysfunction plays an essential role in dementia, however, it is not known whether electrocardiogram autonomic dysfunction-related indicators are associated with the severity of dementia. In this study, we attempted to investigate whether these indicators are correlated in patients with vascular dementia and Alzheimer's disease compared with normal health individuals. For this purpose, we measured and analyzed the predictive value of heart rate deceleration capacity (DC), heart rate deceleration runs (DRs), heart rate acceleration capacity (AC) along with the plasma levels of lipoprotein-associated phospholipase A2 (Lp-PLA2).

Methods: We compared 83 dementia cases including 41 vascular dementia (VD), 42 Alzheimer's disease (AD) patients with 42 elderly health controls. The Mini-Mental State Examination (MMSE) scores, DC, DRs, AC, and Lp-PLA2 levels were comprehensively evaluated.

Results: Our studies showed that DC and DRs in VD and AD groups were significantly lower than those in controls, while AC values were significantly higher. Furthermore, the risk stratification (high- and moderate-) of DC, DRs, and AC in VD and AD groups was increased, while the low-risk was simultaneously decreased. In addition, DC and DRs were positively while AC and Lp-PLA2 were negatively correlated with MMSE scores. Logistic regression analysis indicated that DC, DRs, AC, and Lp-PLA2 were associated with dementia. Moreover, the areas under the ROC curves showed that the combination of five variables and AC + Lp-PLA2 were 0.970 (95% CI, 0.923-0.992) and 0.940 (95% CI, 0.882-0.974) were larger than each single indicator alone.

Conclusion: Distinctive alterations in dynamic electrocardiogram-related indicators reveal a decline in autonomic nervous functions among individuals with dementia. By incorporating comprehensive analyses of DC, DRs, AC, and Lp-PLA2 values, the specificity and sensitivity of dementia diagnosis can be significantly enhanced.