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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Physical activity modifies cognitive impairment-associated mortality risks among chronic kidney disease
Ming-Tsun Tsai1, Yi-Sheng Lin2, Shao-Sung Huang3
1Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Journal of Affective Disorders
|August 26, 2024
Summary
Physical activity (PA) can reduce mortality risk in older adults with chronic kidney disease (CKD) and cognitive impairment. Maintaining high PA levels is associated with lower death risks for CKD patients with mild to severe cognitive impairment.
Area of Science:
- Gerontology
- Nephrology
- Neurology
Background:
- Older adults with chronic kidney disease (CKD) often experience undetected cognitive impairment, leading to increased mortality.
- While physical activity (PA) is known to slow cognitive decline, its effect on mortality risk in CKD patients with cognitive impairment is not well understood.
Purpose of the Study:
- To investigate the combined impact of cognitive impairment and physical activity levels on all-cause and cardiovascular mortality in older Taiwanese CKD patients.
Main Methods:
- A cohort of 30,561 older Taiwanese CKD patients was analyzed from 2005 to 2011.
- Cognitive function was assessed using the Short Portable Mental Status Questionnaire (SPMSQ), categorizing patients into intact, mild, or severe impairment groups.
- Physical activity was classified into high, low, or inactive groups based on weekly moderate-intensity activity duration. Cox regression and survival tree analyses were employed.
Main Results:
- Severe and mild cognitive impairment were significantly associated with increased all-cause mortality (aHRs 2.31 and 1.74, respectively) compared to intact cognition.
- Lower physical activity levels amplified the mortality risks associated with cognitive impairment.
- High PA was linked to reduced mortality in both mild (aHR 0.65) and severe (aHR 0.73) cognitive impairment groups compared to inactivity. Survival tree analysis identified high PA and intact cognition as associated with the lowest mortality.
Conclusions:
- Cognitive impairment, as measured by SPMSQ, shows a dose-dependent relationship with increased mortality in elderly CKD patients.
- Higher levels of physical activity can mitigate the elevated mortality risks associated with cognitive impairment in this population.
- Promoting physical activity may offer significant longevity benefits for older adults with CKD and cognitive impairment.
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