{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T17:50:39Z","timestamp":1769622639211,"version":"3.49.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autonomic dysregulation and cognitive decline often co-occur in aging, but most work uses only resting heart rate variability (HRV). Therefore, we examined whether global cognitive performance modulates dynamic HRV responses to a functional exercise test in community-dwelling older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 104 adults aged 60\u201385 years from southern Chile completed a rest\u2013exercise\u2013recovery protocol using the 2-Min Step Test. Global cognition was assessed with the Addenbrooke\u2019s Cognitive Examination. Short-term HRV (time and frequency domains), parasympathetic (PNS) and sympathetic (SNS) indices, and Baevsky\u2019s Stress Index were derived from Polar H10 recordings at rest, during exercise, and recovery. Hierarchical Bayesian regression models characterized HRV trajectories as a function of cognitive performance, adjusting for body mass index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher cognitive scores were associated with a more favorable autonomic profile at rest, including higher standard deviation of normal-to-normal intervals, low frequency (LF), and very low frequency (VLF) and lower SNS and Stress Index values. During exercise, better cognition was linked to greater high frequency power and larger reductions in LF and VLF from rest to effort, indicating enhanced autonomic flexibility. Lower cognitive scores showed flatter LF\/VLF trajectories and a sharper in-exercise decline in the PNS index. Higher body mass index was consistently related to reduced vagal modulation and higher sympathetic markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older adults with better cognitive performance show healthier resting autonomic profiles and greater adaptability of cardiac autonomic regulation during a brief functional test. Blunted HRV trajectories in individuals with lower cognition may signal early neurophysiological vulnerability, and 2-Min Step Test-derived HRV responses may provide a non-invasive marker of cognitive health in aging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1761743","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:43:42Z","timestamp":1769582622000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From brain to heart: cognitive performance shapes exercise- induced cardiac autonomic trajectories in older adults"],"prefix":"10.3389","volume":"13","author":[{"given":"Paulina","family":"Sep\u00falveda-Figueroa","sequence":"first","affiliation":[{"name":"Departamento de Ciencias Precl\u00ednicas, Facultad de Medicina, Universidad de La Frontera","place":["Temuco, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mat\u00edas","family":"Castillo-Aguilar","sequence":"additional","affiliation":[{"name":"Centro Asistencial Docente e Investigaci\u00f3n (CADI-UMAG), Universidad de Magallanes (UMAG)","place":["Punta Arenas, Chile"]},{"name":"Escuela de Medicina, Universidad de Magallanes (UMAG)","place":["Punta Arenas, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"Sep\u00falveda-Lara","sequence":"additional","affiliation":[{"name":"Doctorado en Ciencias Menci\u00f3n Biolog\u00eda Celular y Molecular Aplicada, Facultad de Ciencias Agropecuarias, Universidad de La Frontera","place":["Temuco, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Escuela de Tecnolog\u00eda M\u00e9dica, Facultad de Salud, Universidad Santo Tom\u00e1s, Los Carreras","place":["Osorno, Chile"]},{"name":"Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera","place":["Temuco, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constanza","family":"Saavedra","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad de Magallanes (UMAG)","place":["Punta Arenas, Chile"]},{"name":"Servicio de Neurolog\u00eda, Hospital Cl\u00ednico de Magallanes","place":["Punta Arenas, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"N\u00fa\u00f1ez-Espinosa","sequence":"additional","affiliation":[{"name":"Centro Asistencial Docente e Investigaci\u00f3n (CADI-UMAG), Universidad de Magallanes (UMAG)","place":["Punta Arenas, Chile"]},{"name":"Escuela de Medicina, Universidad de Magallanes (UMAG)","place":["Punta Arenas, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/S0735-1097(97)00554-8","article-title":"Twenty-four hour time-domain heart rate variability and heart rate: relations to age and gender over nine decades.","volume":"31","author":"Umetani","year":"1998","journal-title":"J Am Coll Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.jmpt.2007.04.001","article-title":"Effect of age and sex on heart rate variability in healthy subjects.","volume":"30","author":"Zhang","year":"2007","journal-title":"J Manipulative Physiol. Ther."},{"key":"B3","doi-asserted-by":"publisher","first-page":"258","DOI":"10.3389\/fpubh.2017.00258","article-title":"An overview of heart rate variability metrics and norms.","volume":"5","author":"Shaffer","year":"2017","journal-title":"Front Public Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"213","DOI":"10.3389\/fpsyg.2017.00213","article-title":"Heart rate variability and cardiac vagal tone in psychophysiological research: recommendations for experiment planning, data analysis, and data reporting.","volume":"8","author":"Laborde","year":"2017","journal-title":"Front Psychol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.ijcard.2009.09.543","article-title":"The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors.","volume":"141","author":"Thayer","year":"2010","journal-title":"Int J Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1016\/S0025-6196(12)62272-1","article-title":"The central autonomic network: functional organization, dysfunction, and perspective.","volume":"68","author":"Benarroch","year":"1993","journal-title":"Mayo Clin Proc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.neubiorev.2008.08.004","article-title":"Claude Bernard and the heart\u2013brain connection: further elaboration of a model of neurovisceral integration.","volume":"33","author":"Thayer","year":"2009","journal-title":"Neurosci Biobehav Rev."},{"key":"B8","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1016\/j.neuron.2013.02.008","article-title":"Visceral influences on brain and behavior.","volume":"77","author":"Critchley","year":"2013","journal-title":"Neuron"},{"key":"B9","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/s12160-009-9101-z","article-title":"Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective.","volume":"37","author":"Thayer","year":"2009","journal-title":"Ann Behav Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"4456","DOI":"10.3390\/ijerph20054456","article-title":"Validity and reliability of short-term heart rate variability parameters in older people in response to physical exercise.","volume":"20","author":"Castillo-Aguilar","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"B11","doi-asserted-by":"publisher","first-page":"769085","DOI":"10.3389\/fphys.2021.769085","article-title":"Cardiac autonomic modulation in response to muscle fatigue and sex differences during consecutive competition periods in young swimmers.","volume":"12","author":"Castillo-Aguilar","year":"2021","journal-title":"Front Physiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1111\/j.1532-5415.2006.00940.x","article-title":"Association between reduced heart rate variability and cognitive impairment in older disabled women.","volume":"54","author":"Kim","year":"2006","journal-title":"J Am Geriatr Soc."},{"key":"B13","doi-asserted-by":"publisher","first-page":"710","DOI":"10.3389\/fnins.2019.00710","article-title":"Heart rate variability and cognitive function:a systematic review.","volume":"13","author":"Forte","year":"2019","journal-title":"Front Neurosci."},{"key":"B14","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00421-004-1208-0","article-title":"Heart rate variability and its relation to prefrontal cognitive function: effects of training and detraining.","volume":"93","author":"Hansen","year":"2004","journal-title":"Eur J Appl Physiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"H132","DOI":"10.1152\/ajpheart.1989.256.1.H132","article-title":"Modulation of cardiac autonomic activity during and immediately after exercise.","volume":"256","author":"Arai","year":"1989","journal-title":"Am J Physiol Heart Circ Physiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1007\/s40279-013-0083-4","article-title":"Cardiac parasympathetic reactivation following exercise: implications for training prescription.","volume":"43","author":"Stanley","year":"2013","journal-title":"Sports Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"301","DOI":"10.3389\/fphys.2017.00301","article-title":"Cardiac autonomic Responses during exercise and post-exercise recovery using heart rate variability and systolic time intervals: a review.","volume":"8","author":"Michael","year":"2017","journal-title":"Front Physiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"10503","DOI":"10.1523\/JNEUROSCI.1103-13.2013","article-title":"The autonomic brain: an activation likelihood estimation meta-analysis.","volume":"33","author":"Beissner","year":"2013","journal-title":"J Neurosci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"4215","DOI":"10.3390\/ijms22084215","article-title":"Obesity, Nutrition and heart rate variability.","volume":"22","author":"Str\u00fcven","year":"2021","journal-title":"Int J Mol Sci."},{"key":"B20","first-page":"81","article-title":"Circadian rhythms in attention.","volume":"92","author":"Valdez","year":"2019","journal-title":"Yale J Biol Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1200\/jco.1984.2.3.187","article-title":"Karnofsky performance status revisited: reliability, validity, and guidelines.","volume":"2","author":"Schag","year":"1984","journal-title":"J Clin Oncol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"CD013282","DOI":"10.1002\/14651858.cd013282.pub2","article-title":"ACE-III and Mini-ACE for detection of dementia and MCI.","volume":"2019","author":"Beishon","year":"2019","journal-title":"Cochrane Database Syst Rev."},{"key":"B23","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/j.nrl.2014.05.004","article-title":"Validation of the Spanish ACE-III for diagnosing dementia.","volume":"30","author":"Matias-Guiu","year":"2015","journal-title":"Neurolog\u00eda"},{"key":"B24","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.nrl.2017.06.004","article-title":"Validaci\u00f3n argentino-chilena del ACE-III [Argentine-chilean validation of ACE-III].","volume":"35","author":"Bruno","year":"2020","journal-title":"Neurolog\u00eda"},{"key":"B25","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1080\/02701367.1999.10608028","article-title":"A 30-s chair-stand test as a measure of lower body strength.","volume":"70","author":"Jones","year":"1999","journal-title":"Res Q Exerc Sport."},{"key":"B26","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.rccar.2019.01.006","article-title":"Variabilidad de la frecuencia cardiaca como factor predictor [Heart rate variability as a predictive factor].","volume":"26","author":"Veloza","year":"2019","journal-title":"Rev Colomb Cardiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1007\/s00421-009-1317-x","article-title":"Monitoring endurance running performance using cardiac parasympathetic function.","volume":"108","author":"Buchheit","year":"2010","journal-title":"Eur J Appl Physiol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1111\/j.1469-8986.1997.tb02140.x","article-title":"Heart rate variability: origins, methods, and interpretive caveats.","volume":"34","author":"Berntson","year":"1997","journal-title":"Psychophysiology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"H451","DOI":"10.1152\/ajpheart.00008.2006","article-title":"Cardiac parasympathetic regulation: associations with fitness and training load.","volume":"291","author":"Buchheit","year":"2006","journal-title":"Am J Physiol Heart Circ Physiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1007\/s11517-006-0119-0","article-title":"Heart rate variability: a review.","volume":"44","author":"Acharya","year":"2006","journal-title":"Med Biol Eng Comput."},{"key":"B31","volume-title":"Methodical Recommendations: Use of KARDiVAR System for Determination of the Stress Level and Estimation of the Body Adaptability. Standards of Measurements and Physiological Interpretation.","author":"Baevsky","year":"2009"},{"key":"B32","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1159\/000513781","article-title":"HRV-measured stress and academic achievement in medical students.","volume":"30","author":"Yoo","year":"2021","journal-title":"Med. Princ. Pract."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s43586-020-00001-2","article-title":"Bayesian statistics and modelling.","volume":"1","author":"van de Schoot","year":"2021","journal-title":"Nat. Rev. Methods Primers"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2767","DOI":"10.3389\/fpsyg.2019.02767","article-title":"Indices of effect existence in the Bayesian framework.","volume":"10","author":"Makowski","year":"2019","journal-title":"Front. Psychol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"40714","DOI":"10.31083\/rcm40714","article-title":"Effects of long-term moderate-intensity exercise on autonomic dysfunction.","volume":"26","author":"Zhao","year":"2025","journal-title":"Rev Cardiovasc Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"102521","DOI":"10.1016\/j.arr.2024.102521","article-title":"HRV and autonomic imbalance: biomarkers of aging.","volume":"101","author":"Olivieri","year":"2024","journal-title":"Ageing Res. Rev."},{"key":"B37","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1186\/s12888-025-07256-7","article-title":"HRV and inflammatory markers in first-episode depression.","volume":"25","author":"Alimu","year":"2025","journal-title":"BMC Psychiatry"},{"key":"B38","doi-asserted-by":"publisher","first-page":"102016","DOI":"10.1016\/j.arr.2023.102016","article-title":"Autonomic nervous system flexibility for understanding brainaging.","volume":"90","author":"Lin","year":"2023","journal-title":"Ageing Res Rev."},{"key":"B39","doi-asserted-by":"publisher","first-page":"74","DOI":"10.3390\/neurolint17050074","article-title":"Cardiac autonomic modulation and cognitive performance in older adults.","volume":"17","author":"Maduro","year":"2025","journal-title":"Neurol Int."},{"key":"B40","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s11556-021-00278-6","article-title":"Effects of exercise interventions on HRV and cardiovascular factors: a systematic review.","volume":"18","author":"Gr\u00e4ssler","year":"2021","journal-title":"Eur Rev. Aging Phys. Act."},{"key":"B41","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1186\/s13063-021-05530-z","article-title":"Targeting autonomic flexibility to enhance cognitive training outcomes.","volume":"22","author":"Lin","year":"2021","journal-title":"Trials."},{"key":"B42","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1161\/HYPERTENSIONAHA.124.24001","article-title":"Baroreflex sensitivity and long-term dementia risk.","volume":"82","author":"Ma","year":"2025","journal-title":"Hypertension."},{"key":"B43","doi-asserted-by":"publisher","first-page":"626","DOI":"10.3389\/fnhum.2016.00626","article-title":"Mediators of physical activity on neurocognitive function: a multi-level review.","volume":"10","author":"Stillman","year":"2016","journal-title":"Front Hum Neurosci."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1761743\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:43:43Z","timestamp":1769582623000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1761743\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":43,"alternative-id":["10.3389\/fmed.2026.1761743"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1761743","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"article-number":"1761743"}}