Associations Between Autonomic Nervous System Activity and Frailty in Community-Dwelling Older Women

BACKGROUND: The autonomic nervous system (ANS) is associated with various physical and psychological conditions. OBJECTIVE: We examined the relationship between ANS activity-measured using pulse-rate variability-and physical, psychological, and social frailty in community-dwelling older women. METHODS: In 2024, we conducted a cross-sectional survey in Japan with 119 community-dwelling women aged 65 years or older. The survey assessed ANS activity and physical performance and included a self-administered questionnaire. We measured ANS activity using pulse-rate variability for 5 minutes and calculated total power, low frequency, high frequency, and the low-frequency-high-frequency ratio. We measured physical performance (eg, grip strength and walking speed) and included items on weight, depression symptoms, drinking, and smoking. We conducted binary logistic regression for physical and psychological frailty and ordinal logistic regression for social frailty, using ANS indicators as independent variables. RESULTS: Thirty-five participants (29.4%) were classified as physically frail or pre-frail, 33 (27.7%) as psychologically frail or pre-frail, and 68 (57.6%) as socially frail or pre-frail. For physical frailty, total power, low frequency, and high frequency were lower in the frailty group than in the nonfrailty group. In addition, total power and high frequency were lower in the social frailty group compared with the non-frailty group. By contrast, no significant associations were observed between pulse-rate variability indices and psychological frailty. CONCLUSIONS: People with physical and social frailty may show lower ANS activity. Improving ANS activity through lifestyle habits and group exercise may be a potential avenue for preventing frailty.