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Intradialytic Cognitive and Aerobic Exercise Training to Preserve Cognitive Function: IMPCT, a Multi-Dialysis Center

Nidhi Ghildayal1, Yi Liu1, Jingyao Hong1

  • 1Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA.

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Cognitive training and exercise may improve global cognitive function and perceived health in hemodialysis patients. Further research is needed to confirm long-term benefits of these interventions for end-stage kidney disease patients.

Keywords:
Clinical trialCognitive and physical interventionCognitive functionDialysisEnd-stage kidney disease

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Area of Science:

  • Nephrology
  • Neuroscience
  • Gerontology

Background:

  • End-stage kidney disease (ESKD) patients often experience cognitive impairment due to comorbidities and dialysis.
  • Cognitive training (CT) and exercise training (ET) show promise for preserving cognition in older adults.
  • These interventions can be adapted for individuals undergoing in-center hemodialysis.

Purpose of the Study:

  • To evaluate the effectiveness of intradialytic web-based cognitive training (CT) and exercise training (ET) on cognitive function in hemodialysis patients.
  • To assess the impact of combined CT and ET on executive function and global cognitive function.
  • To examine patient-centered outcomes, including perceived health.

Main Methods:

  • A 2x2 factorial randomized controlled trial (IMPCT) involving 121 adult hemodialysis patients.
  • Participants were randomized into four groups: control, CT only, ET only, and combined CT+ET.
  • Assessments for executive function, global cognition, and clinical/patient-centered outcomes were conducted at baseline and 3 months.

Main Results:

  • No significant differences in 3-month executive function change were observed across the study arms.
  • The combined CT+ET group showed a significant improvement in global cognitive function (Montreal Cognitive Assessment score difference=2.1).
  • The ET group reported a significant improvement in perceived health change (score difference=0.8).

Conclusions:

  • Combined cognitive training and exercise training may enhance short-term global cognitive function in hemodialysis patients.
  • Exercise training alone may improve perceived health in this population.
  • Long-term effects of CT and ET in ESKD patients require further investigation.