Evaluation of Parasympathetic Nerve Function Status in Healthy Elderly Subjects

Abstract

Background: Autonomic control on cardiovascular activity is modified with age. Impaired autonomic nerve functions are common features of patients suffering from cardiovascular diseases particularly in old age.
Objective: To observe the influence of aging process on parasympathetic nerve function.
Study design: This observational study was conducted in the Department of Physiology, BSMMU, Dhaka during the period of July 2005 to June 2006. For this purpose, 60 apparently healthy elderly subjects of both sexes were selected as study group and divided into two groups-one group consisted of 30 elderly subjects with age ranged from 51-60 years and another group consisted of 30 elderly subjects with age ranged from 61-70 years. Thirty sex and BMI matched healthy adults with age ranged from 21-30 years were studied as control.
Methods: Parasympathetic nerve function status of all the subjects were assessed by three simple non-invasive cardiovascular reflex tests. These were heart rate response to valsalva maneuver, heart rate response to deep breathing and heart rate response to standing (30th:15th ). For statistical analysis one way ANOVA (Post Hoc Test) and the Pearson's correlation co-efficient tests were done.
Results: Mean (± SD) of valsalva ratio were 1.50±0.23, 1.32±0.14 and 1.28±0.15; HR response to deep breathing test were 25.36±3.90, 18.82±3.35 and 15.96±3.54 beats/min; 30th:15th ratio in standing test were 1.100.06, 1.05±0.03 and 1.04±0.02 in 21- 30, 51-60 and 61-70 years age groups respectively. All the 3 parameters were significantly lower in both elderly groups compared to that of control adults (p < 0.001) Again, HR response to deep breathing was significantly lower in 61-70 years age group compared to that of 51-60 years age group. Valsalva ratio and 30th:15th ratio were also lower in 61-70 years age group than that of 51-60 years group but the differences were not statistically significant. All the 3 parameters were negatively correlated with age which were statistically significant.
Conclusion: From this study it may concluded that aging process substantially impaired cardiovascular parasympathetic nerve functions.

Key words: Cardiovascular reflex test, elderly person.      

doi: 10.3329/jbsp.v3i0.1790

J Bangladesh Soc Physiol.2008 Dec;(3):23-28.