Response of heart rate variability after postural change and its relationship with determinants of frailty in hospitalized older adults
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Abstract
Introduction: Frailty in the elderly causes significant functional impairments, increased hospitalizations, and changes in cardiac autonomic control. During hospitalization, these impairments may be aggravated. Objective: To identify frailty and assess the response of heart rate variability (HRV) and its relationship with factors that contribute to frailty in hospitalized elderly people. Methods: Cross-sectional study at a university hospital. Older adults aged ≥60 years, with preserved cognition, hemodynamic, and respiratory stability. Clinical data, HRV monitoring, Charlson and Barthel indices, International Physical Activity Questionnaire (IPAQ), Mini Nutritional Assessment (MNAr), Appendicular Skeletal Muscle Mass Index (ASMI), handgrip strength (HGS), and gait speed test (GST) were recorded. Shapiro-Wilk, One-Way ANOVA or Kruskal-Wallis, t-test or Mann-Whitney test, and Pearson or Spearman correlation were applied, adopting a p≤0.05. Results: Forty elderly individuals, aged 70.28±7.06 years, were evaluated; only 11 did not present frailty criteria (27.5%), 21 were characterized as pre-frail (52.5%), and 8 were frail (20%). The HRV response correlated with the GST (rs 0.88, p=0.01), Charlson (rs -0.56, p=0.02), MNAr (rs 0.81, p=0.02), and ASMI (rs 0.82, p=0.04). HRV was similar at rest and after postural change between the frailty subgroups. Conclusion: In this sample, the majority presented frailty criteria. HRV values at rest and after postural change were similar between the subgroups. The HRV response was associated with functionality, physical activity, nutrition, and mortality.
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