Association between Physical Performance and Autonomic Nervous System in Elderly Fallers

Falls among older adults have become a global concern. Autonomic nervous system (ANS) function, which is implicated, can be noninvasively evaluated with heart rate variability (HRV) and blood pressure variability (BPV). The present study evaluated relationship between physical activity, physical performance and autonomic function in 92 older individuals. Continuous non-invasive cardiovascular autonomic reflexes were monitored over 5 minutes supine rest and 3 minutes standing upright. Our findings suggest that elderly fallers had poorer autonomic function, lower hand-grip strength (p< 0.001), poorer walking ability (TUG: p=0.004), greater dependence in instrumental activities of daily living (Lawton IADL: p< 0.001) and lower physical activity level (PASE: p< 0.001). Overall, Lawton IADL, PASE and Time-up and Go were significantly associated with autonomic function indices (LF-nu, HF-nu, LF/HF) and could be served as pre-screening tools to identify patients with autonomic dysfunction. Identification of specific autonomic function risk factors can be useful in the early prevention and diagnosis of recurrent falls and cardiovascular risk.