Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)

Background: This study aimed to investigate the neurocardiovascular responses during an Active Stand (AS) test, utilizing both pre-processed and raw signals, to predict adverse health outcomes including orthostatic intolerance (OI) during the AS, and future falls and mortality. Methods: A total of 2...

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Main Authors: Feng Xue, Roman Romero-Ortuno
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Sensors
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Online Access:https://www.mdpi.com/1424-8220/25/11/3548
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author Feng Xue
Roman Romero-Ortuno
author_facet Feng Xue
Roman Romero-Ortuno
author_sort Feng Xue
collection DOAJ
description Background: This study aimed to investigate the neurocardiovascular responses during an Active Stand (AS) test, utilizing both pre-processed and raw signals, to predict adverse health outcomes including orthostatic intolerance (OI) during the AS, and future falls and mortality. Methods: A total of 2794 participants from The Irish Longitudinal Study on Ageing (TILDA) were included. Continuous cardiovascular (heart rate (HR), systolic (sBP), and diastolic (dBP) blood pressure) and near infra-red spectroscopy-based neurovascular (tissue saturation index (TSI), oxygenated hemoglobin (O<sub>2</sub>Hb), and deoxygenated hemoglobin (HHb)) signals were analyzed using Statistical Parametric Mapping (SPM) to identify significant group differences across health outcomes. Results: The results demonstrated that raw (unprocessed) signals, particularly O<sub>2</sub>Hb and sBP/dBP, were more effective in capturing significant physiological differences associated with mortality and OI compared to pre-processed signals. Specifically, for OI, raw sBP and dBP captured significant changes across the entire test, whereas pre-processed signals showed intermittent significance. TSI captured OI only in its pre-processed form, at approximately 10 s post-stand. For mortality, raw O<sub>2</sub>Hb was effective throughout the AS test. No significant differences were observed in either pre-processed or raw signals related to falls, suggesting that fall risk may require a multifactorial assessment beyond neurocardiovascular responses. Conclusions: These findings highlight the potential utility of raw signal analysis in improving risk stratification for OI and mortality, with further studies needed to validate these findings and refine predictive models for clinical applications. This study underscores the importance of retaining raw data for certain physiological assessments and provides a foundation for future work in developing machine-learning models for early health outcome detection.
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spelling doaj-art-15a07ac3f29f412fac55f821c4f06b5a2025-08-20T03:11:24ZengMDPI AGSensors1424-82202025-06-012511354810.3390/s25113548Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)Feng Xue0Roman Romero-Ortuno1Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandDiscipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, IrelandBackground: This study aimed to investigate the neurocardiovascular responses during an Active Stand (AS) test, utilizing both pre-processed and raw signals, to predict adverse health outcomes including orthostatic intolerance (OI) during the AS, and future falls and mortality. Methods: A total of 2794 participants from The Irish Longitudinal Study on Ageing (TILDA) were included. Continuous cardiovascular (heart rate (HR), systolic (sBP), and diastolic (dBP) blood pressure) and near infra-red spectroscopy-based neurovascular (tissue saturation index (TSI), oxygenated hemoglobin (O<sub>2</sub>Hb), and deoxygenated hemoglobin (HHb)) signals were analyzed using Statistical Parametric Mapping (SPM) to identify significant group differences across health outcomes. Results: The results demonstrated that raw (unprocessed) signals, particularly O<sub>2</sub>Hb and sBP/dBP, were more effective in capturing significant physiological differences associated with mortality and OI compared to pre-processed signals. Specifically, for OI, raw sBP and dBP captured significant changes across the entire test, whereas pre-processed signals showed intermittent significance. TSI captured OI only in its pre-processed form, at approximately 10 s post-stand. For mortality, raw O<sub>2</sub>Hb was effective throughout the AS test. No significant differences were observed in either pre-processed or raw signals related to falls, suggesting that fall risk may require a multifactorial assessment beyond neurocardiovascular responses. Conclusions: These findings highlight the potential utility of raw signal analysis in improving risk stratification for OI and mortality, with further studies needed to validate these findings and refine predictive models for clinical applications. This study underscores the importance of retaining raw data for certain physiological assessments and provides a foundation for future work in developing machine-learning models for early health outcome detection.https://www.mdpi.com/1424-8220/25/11/3548neurocardiovascular responseactive standadverse health outcomescontinuous physiological monitoringsignal preprocessingneurovascular
spellingShingle Feng Xue
Roman Romero-Ortuno
Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)
Sensors
neurocardiovascular response
active stand
adverse health outcomes
continuous physiological monitoring
signal preprocessing
neurovascular
title Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)
title_full Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)
title_fullStr Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)
title_full_unstemmed Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)
title_short Linking Neurocardiovascular Responses in the Active Stand Test to Adverse Outcomes: Insights from the Irish Longitudinal Study on Ageing (TILDA)
title_sort linking neurocardiovascular responses in the active stand test to adverse outcomes insights from the irish longitudinal study on ageing tilda
topic neurocardiovascular response
active stand
adverse health outcomes
continuous physiological monitoring
signal preprocessing
neurovascular
url https://www.mdpi.com/1424-8220/25/11/3548
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