Heart Rate and its Variability from Short-term ECG Recordings as Biomarkers for Detecting Mild Cognitive Impairment in Indian Population

Abstract

Alterations in Heart Rate (HR) and Heart Rate Variability (HRV) can reflect autonomic dysfunction associated with neurodegeneration. We investigate the influence of Mild Cognitive Impairment (MCI) on HR and its variability measures in the Indian population by designing a complete signal processing pipeline to detect the R-wave peaks and compute HR and HRV features from ECG recordings of 10 seconds, for point-of-care applications. The study cohort involves 297 urban participants, among which 48.48% are male and 51.51% are female. From the Addenbrooke's Cognitive Examination-III (ACE-III), MCI is detected in 19.19% of participants and the rest, 80.8% of them are cognitively healthy. Statistical features like central tendency (mean and root mean square (RMS) of the Normal-to-Normal (NN) intervals) and dispersion (standard deviation (SD) of all NN intervals (SDNN) and root mean square of successive differences of NN intervals (RMSSD)) of beat-to-beat intervals are computed. The Wilcoxon rank sum test reveals that mean of NN intervals (p = 0.0021), the RMS of NN intervals (p = 0.0014), the SDNN (p = 0.0192) and the RMSSD (p = 0.0206) values differ significantly between MCI and non-MCI classes, for a level of significance, 0.05. Machine learning classifiers like, Support Vector Machine (SVM), Discriminant Analysis (DA) and Naive Bayes (NB) driven by mean NN intervals, RMS, SDNN and RMSSD, show a high accuracy of 80.80% on each individual feature input. Individuals with MCI are observed to have comparatively higher HR than healthy subjects. HR and its variability can be considered as potential biomarkers for detecting MCI.