Association between dysfunction of autonomic nervous system activity and mortality in schizophrenia

Patients with schizophrenia have a higher mortality risk than the general population. Additionally, the autonomic nervous system (ANS) activity of patients with schizophrenia is lower and more dysfunctional than that of the general population. Nonetheless, the association between ANS dysfunction and mortality in schizophrenia is unclear. The aim of this study was to investigate the association between ANS activity and mortality in schizophrenia and to evaluate the predictive values of heart rate variability for long-term survival. This study involves the 10-year follow-up of a sample population consisting of 59 Japanese inpatients with schizophrenia between 60 and 70 years of age from 2007 to 2016. The ANS activity of all patients was evaluated using heart rate variability in 2007. Fifty-three participants could be followed up because they stayed in the hospital during the follow-up period. Of these patients, 11 died during follow-up. Their mean age at death was 70.55 ± 3.45 years. The parasympathetic activity of nonsurvivors was significantly lower than that of survivors, and multiple logistic regression analysis showed a significant association between death and parasympathetic activity. We suggest that decreased parasympathetic activity could be associated with 10-year all-cause mortality in older schizophrenic patients. •Parasympathetic activity in schizophrenia was significantly lower in nonsurvivors.•Decreased vagal activity is associated with 10-year all-cause mortality in schizophrenia.•Cardiovascular or infectious risks should be considered in schizophrenia with lower HF HRV.