A1 Journal article (refereed)
Autonomic nervous system and postural control regulation during orthostatic test as putative markers of physical resilience among community-dwelling older adults (2023)


Koivunen, K., Löppönen, A., Palmberg, L., Rantalainen, T., Rantanen, T., & Karavirta, L. (2023). Autonomic nervous system and postural control regulation during orthostatic test as putative markers of physical resilience among community-dwelling older adults. Experimental Gerontology, 182, Article 112292. https://doi.org/10.1016/j.exger.2023.112292


JYU authors or editors


Publication details

All authors or editors: Koivunen, Kaisa; Löppönen, Antti; Palmberg, Lotta; Rantalainen, Timo; Rantanen, Taina; Karavirta, Laura

Journal or series: Experimental Gerontology

ISSN: 0531-5565

eISSN: 1873-6815

Publication year: 2023

Volume: 182

Article number: 112292

Publisher: Elsevier

Publication country: United States

Publication language: English

DOI: https://doi.org/10.1016/j.exger.2023.112292

Publication open access: Openly available

Publication channel open access: Open Access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/89274


Abstract

Introduction
We examined whether autonomic nervous system (ANS) and postural control regulation during orthostatic test reflect physical resilience by studying their associations with maximal walking speed and mortality.

Methods
The participants were community-dwelling Finnish men (n = 303) and women (n = 386) aged 75, 80, and 85 years at baseline. Systolic and diastolic blood pressure (BP), heart rate, heart rate variability (HRV), respiratory rate, and postural sway were obtained using a digital sphygmomanometer, a single-channel ECG, and thigh- and chest-worn accelerometers. Linear and Cox regression models were used to estimate the associations of the physiological indices with maximal 10-m walking speed and 5-year mortality separately for sexes.

Results
Better maintenance of BP under orthostatic stress was associated with faster walking speed in women and lower mortality hazard in men. Greater HRV in terms of low frequency power and lower respiration rate in supine position and smaller orthostatic changes in these were associated with faster walking speed especially in women. Less postural sway after standing up was associated with faster walking speed in women (−0.057, SE 0.022, p = 0.011) and more postural sway with increased mortality hazard in men (HR 1.71, 95 % CI 1.20–2.43) even after controlling for BP responses.

Conclusions
In addition to ANS regulation at rest and under stress, adaptation of postural control system to orthostasis may be used in quantifying older adults' physical resilience. Wearable sensors capturing stimulus-response patterns and natural fluctuations of body functions may provide opportunities to monitor and incorporate different subsystems' resilience also in free-living conditions.


Keywords: mortality; adaptation (change); walking (motion); autonomic nervous system

Free keywords: adaptation; orthostatic stress; stimulus-response patterns; walking speed; mortality


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Ministry reporting: Yes

VIRTA submission year: 2023

JUFO rating: 1


Last updated on 2024-03-07 at 01:27