Physical Activity Is Critical To Preserve Cognitive Function In Nephrology Patients

Abstract

Chronic kidney disease (CKD) associates with earlier onset of cognitive impairment. Physical activity (PA) improves neuronal plasticity and cognitive function among older adults. However, limited data exist exploring the effect of PA on cognitive function in CKD patients. PURPOSE: To investigate the effect of regular physical activity on cognitive function in CKD patients. METHODS: We analyzed 68 patients with CKD admitted to a Midwestern hospital between January 2017 and July 2018. All subjects provided a health history, had a comprehensive metabolic panel with estimated glomerular filtration rate (eGFR), and reported whether they engaged in regular physical activity (PA). Cognitive impairments, including dementia, Alzheimer's, and Parkinson's disease were documented. Independent-samples t-tests and chi-squared tests compared patient profiles between sedentary and active patients. Logistic regression analyses tested the effect of PA on cognitive impairments holding constant other significant predictors. RESULTS: Patients were 64.7 ± 17.4 years old, had an eGFR of 24.7 ± 13.8 mL/min, 66.2% were sedentary, and 25.0% had a cognitive impairment. Older subjects were more likely to have a diagnosis of cognitive impairment (p=0.051) and the prevalence was higher in sedentary patients (33.3%) than in those who were physically active (8.7%; p=0.026). Holding constant the age of the patient and the stage of CKD, engagement in PA shared a trending association with mental impairment (p=0.056), predicting a 79.8% reduction in the likelihood of diagnosis (Pseudo R2 = 0.187; 95% CI of OR: 0.039 to 1.040). Similarly, controlling for eGFR rather than CKD stage, the significance of PA as a predictor remained stable (p=0.057; 95% CI of OR: 0.039 to 1.052). CONCLUSIONS: Patients with CKD experience a higher risk of cognitive impairment than age-matched controls. In our sample, engagement in regular physical activity demonstrated a protective effect, and sedentary behavior influenced diagnosis more than age.