Background/Objectives: Cognitive decline has been increasingly linked to cardiac autonomic regulation; however, its specific associations with cognitive domains, such as information processing speed and executive function, remain unclear. This preliminary study examined the relationship between cardiac autonomic modulation and cognitive performance in older adults. Methods: A cross-sectional study was conducted with 101 older adults (aged ≥60 years) attending a university hospital outpatient clinic. Participants were classified as without cognitive impairment (WCI) or cognitively impaired and not demented (CIND) based on neuropsychological assessments. Heart rate variability (HRV) was measured at rest, focusing on the time-domain parameters (SDNN, rMSSD, and pNN50). Trail making test parts A and B (TMT-A and TMT-B) were used to assess information processing speed and executive function, respectively. Analyses of covariance (ANCOVAs) were performed, adjusting for confounding variables including age, sex, and comorbidities. Results: Participants in the CIND group had significantly lower HRV indices than those in the WCI group (SDNN, p < 0.05, d = 0.44; rMSSD, p < 0.05, d = 0.39; pNN50, p < 0.05, d = 0.40), indicating reduced parasympathetic modulation. Higher HRV values were observed in individuals with preserved processing speed and executive function. Specifically, pNN50 was significantly associated with processing speed (p = 0.04), and SDNN was significantly correlated with executive function (p = 0.02). These associations persisted even after adjusting for confounding factors. Conclusions: Reduced cardiac autonomic modulation, especially lower parasympathetic activity, is significantly associated with cognitive impairment in older adults. Lower pNN50 values were correlated with slower information processing speed, and lower SDNN was associated with poorer executive function. These findings support the potential use of HRV as a physiological biomarker to detect cognitive changes during ageing.

Early detection of cognitive decline in older adults is essential for implementing timely interventions. This study aimed to compare the diagnostic accuracy of the Mini-Mental State Examination (MMSE^®) and the Montreal Cognitive Assessment (MoCA©) in identifying cognitive impairment among community-dwelling older adults, while considering the effect of educational level. A cross-sectional, analytical study was conducted with 90 individuals aged 60 years or older, classified into cognitively preserved and cognitively impaired groups using the Clinical Dementia Rating (CDR) scale. Cognitive performance was assessed using the MMSE and MoCA, with results analyzed using both standard and education-adjusted cut-off scores. Diagnostic accuracy was evaluated using Receiver Operating Characteristic (ROC) curves. The MoCA demonstrated superior discriminative ability compared to the MMSE, with a significantly larger area under the ROC curve (AUC = 0.943 vs. 0.826; p < 0.001), higher sensitivity (90.2% vs. 78.4%), and higher specificity (87.2% vs. 76.9%). When education-adjusted cut-off scores were applied, the MoCA achieved markedly improved diagnostic accuracy (87.8%) compared to the MMSE (71.1%), with stronger agreement with CDR classifications (κ = 0.746 vs. κ = −0.132). These findings demonstrate that the MoCA is more sensitive in detecting cognitive impairment and should be considered the preferred screening tool in clinical and research settings, particularly when appropriate educational adjustments are applied.

Early detection of cognitive decline in older adults is essential for implementing timely interventions. This study aimed to compare the accuracy of the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in identifying cognitive impairment in community-dwelling older adults, while considering the effect of educational level. A cross-sectional, analytical study was conducted with 101 individuals aged 60 years or older, classified into cognitively intact and cognitively impaired non-demented (CIND) groups. Cognitive performance was assessed using the MMSE and MoCA, and the results were adjusted for years of schooling. Diagnostic accuracy was analyzed using Receiver Operating Characteristic (ROC) curves. The MoCA showed superior performance compared to the MMSE, with a significantly larger area under the ROC curve (AUC = 0.861 vs. 0.782; p = 0.037), particularly among participants with ≤ 8 years of education. These findings suggest that the MoCA is more sensitive in detecting early cognitive impairment and should be considered a preferable screening tool in clinical and research settings, especially in populations with heterogeneous educational backgrounds.

Background/Objectives: Cognitive decline has been increasingly linked to cardiac autonomic control, yet its relationship with specific cognitive domains, such as information processing speed and executive function, remains unclear. This study investigated the association between cardiac autonomic modulation and cognitive performance in older adults. Methods: A cross-sectional study was conducted with 101 older adults (≥60 years) from a university hospital outpatient clinic. Participants were classified as cognitively intact (WCI) or cognitively impaired but not demented (CIND) based on neuropsychological assessment. Heart rate variability (HRV) was assessed under resting conditions, focusing on time-domain parameters (SDNN, rMSSD, and pNN50). The Trail Making Test Part A (TMT-A) and Part B (TMT-B) were used to evaluate information processing speed and executive function, respectively. ANCOVA models were applied to adjust for confounders such as age, sex, and comorbidities. Results: The CIND group exhibited significantly lower HRV indices (SDNN: p<0.05, d=0.44; rMSSD: p<0.05, d=0.39; pNN50: p<0.05, d=0.40), suggesting reduced parasympathetic modulation. Participants with preserved processing speed and executive function displayed higher HRV values, with pNN50 significantly associated with processing speed (p=0.04) and SDNN with executive function (p=0.02). ANCOVA confirmed that these associations remained significant after adjusting for confounders. Conclusions: Reduced cardiac autonomic modulation, particularly parasympathetic activity, is associated with cognitive impairment in aging. Lower pNN50 was linked to slower processing speed, while lower SDNN correlated with impaired executive function, reinforcing the potential of HRV as a biomarker for neurophysiological alterations in cognition.