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Association of Cognitive Function Screening Results with Adherence and Performance in a Pedometer-Based Intervention
Anoop Sheshadri1,2, Piyawan Kittiskulnam3,4, Cynthia Delgado1,2
1Nephrology Section, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
American Journal of Nephrology
|May 12, 2021
Summary
Cognitive impairment in dialysis patients was linked to lower adherence and reduced benefits from a pedometer-based walking program. Future interventions should consider strategies to support patients with cognitive challenges.
Area of Science:
- Nephrology
- Geriatrics
- Cognitive Neurology
Background:
- Dialysis patients often experience reduced physical activity and cognitive decline.
- Pedometer-based walking interventions can improve physical function in this population.
- The impact of cognitive function on adherence and outcomes in such interventions is not well understood.
Purpose of the Study:
- To investigate the association between cognitive function impairment and adherence to a pedometer-based walking intervention.
- To determine if cognitive status influences the effectiveness of the intervention in improving physical activity and performance.
Main Methods:
- A 3-month randomized controlled trial involving 30 dialysis patients using a pedometer-based intervention with weekly goals.
- Cognitive function was assessed using the Telephone Interview of Cognitive Status (TICS).
- Adherence, goal achievement, and changes in physical activity (steps), physical performance (Short Physical Performance Battery - SPPB), and self-reported physical function (PF) were analyzed using regression models.
Main Results:
- One-third of participants were cognitively unimpaired, with 13% having mild cognitive impairment (MCI).
- Worse cognitive function was associated with lower adherence (missed calls, fewer goals achieved) and smaller increases in steps, SPPB, and PF during and after the intervention.
- Specific reductions in step increases, SPPB, and PF were observed in participants with ambiguous impairment and MCI compared to unimpaired individuals.
Conclusions:
- Cognitive impairment in dialysis patients is associated with poorer adherence and reduced benefits from pedometer-based walking interventions.
- Exercise interventions for dialysis patients should incorporate strategies to manage cognitive impairment, potentially involving caregivers.
