ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Functional Data Analysis of Heart Rate Variability from Continuous ECG Monitoring in Older Adults with and without Mild Cognitive Impairment
Provisionally accepted
- 1Albert Einstein College of Medicine, New York City, United States
- 2Albert Einstein College of Medicine, New York, United States
- 3New York-Presbyterian/Columbia University Irving Medical Center, New York, United States
- 4New York State Psychiatric Institute, New York, United States
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Background: Reduced heart rate variability (HRV) has been associated with cognitive decline in older adults. However, prior research relied on brief in-clinic ECG recordings to measure HRV. Using 7-day continuous ambulatory ECG monitoring, we investigated time-specific differences in HRV (i.e., the difference in HRV at each timepoint over a 24-hour day) between people with mild cognitive impairment (MCI) and those who were cognitively normal (CN), in a cohort of community-dwelling older adults. Methods: Analyses included 81 dementia-free participants (Mean age=78, SD=5, Range=72–95; 82% Female; 38% Non-Hispanic White, 43% Non-Hispanic Black). Among them, 20 met the Jak/Bondi criteria for MCI. Participants wore a single lead ECG monitor continuously for 7 days. Power spectral analyses were applied to determine HRV in the high frequency band (0.15-0.40 Hz, HF-HRV) over consecutive 5-minute epochs throughout the recording. Functional additive mixed models were applied to participants' 24-hour HF-HRV profiles to examine time-specific HRV differences between MCI and CN, controlling for age, sex, race/ethnicity, education and further controlling for depression, history of diabetes and hypertension. Results: Compared to the CN group, the MCI group showed reduced HRV in the early morning (<7am) and evening (>7pm), with the greatest difference occurring around midnight (difference: 0.6, 95% pointwise CI: 0.2, 1.1, Cohen's d: 0.75). Conclusions: Our findings highlight HRV's dynamic nature and the need to consider time of the day when investigating the relationship between HRV and cognition. Compared to daytime HRV, reduced nighttime HRV may have a stronger association with worse cognition. Keywords: heart rate variability; cognition; aging; functional data analysis; ambulatory measures.
Keywords: Heart rate variability, Cognition, Aging, functional data analysis, ambulatory measures
Received: 17 Sep 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Qin, Derby, LIU, Wang and Sloan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiyue Qin
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