{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:48:30Z","timestamp":1792759710949,"version":"4.5.0"},"reference-count":87,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T00:00:00Z","timestamp":1637798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Disease","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Disease","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K01AG064040"],"award-info":[{"award-number":["K01AG064040"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24AI144954"],"award-info":[{"award-number":["K24AI144954"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG055781"],"award-info":[{"award-number":["R01AG055781"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01DK120518"],"award-info":[{"award-number":["R01DK120518"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01DK114074"],"award-info":[{"award-number":["R01DK114074"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008795","name":"Manitoba Medical Services Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,19]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cognitive impairment is common among persons with chronic kidney disease (CKD), due in part to reduced kidney function. Given that physical activity (PA) is known to mitigate cognitive decline, we examined whether associations between CKD stage and global\/domain-specific cognitive function differ by PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We leveraged 3223 participants (\u226560 years of age) enrolled in National Health and Nutrition Examination Survey (NHANES, 2011\u20132014), with at least one measure of objective cognitive function [immediate recall (CERAD-WL), delayed recall (CERAD-DR), verbal fluency (AF), executive function\/processing speed (DSST), global (average of four tests) or self-perceived memory decline (SCD)]. We quantified the association between CKD stage {no CKD: estimated glomerular filtration rate [eGFR]\u00a0\u226560\u00a0mL\/min\/1.73 m2 and albuminuria [albumin:creatinine ratio (ACR)] &amp;lt;30\u00a0mg\/g; stages G1\u2013G3: eGFR\u00a0\u226560 mL\/min\/1.73 m2\u00a0and ACR \u226530\u00a0mg\/g\u00a0or\u00a0eGFR 30\u201359 mL\/min\/1.73 m2;\u00a0stages G4 and G5: eGFR\u00a0&amp;lt;30 mL\/min\/1.73 m2}\u00a0and\u00a0cognitive function using linear regression (objective measures) and logistic regression (SCD), accounting for sampling weights for nationally representative estimates. We tested whether associations differed by PA [Global Physical Activity Questionnaire, high PA\u00a0\u2265600 metabolic equivalent of task (MET)\u2009\u00b7\u2009min\/week versus low PA\u00a0&amp;lt;600 MET\u2009\u00b7\u2009min\/week] using a Wald test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among NHANES participants, 34.9% had CKD stages G1\u2013G3, 2.6% had stages G4 and G5 and 50.7% had low PA. CKD stages G4 and G5 were associated with lower global cognitive function {difference = \u22120.38 standard deviation [SD] [95% confidence interval (CI) \u22120.62 to \u22120.15]}. This association differed by PA (Pinteraction\u00a0=\u00a00.01). Specifically, among participants with low PA, those with CKD stages G4 and G5 had lower global cognitive function [difference = \u22120.57 SD (95% CI \u22120.82 to \u22120.31)] compared with those without CKD. Among those with high PA, no difference was found [difference\u00a0=\u00a00.10 SD (95% CI \u22120.29\u20130.49)]. Similarly, the CKD stage was only associated with immediate recall, verbal fluency, executive function and processing speed among those with low PA; no associations were observed for delayed recall or self-perceived memory decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CKD is associated with lower objective cognitive function among those with low but not high PA. Clinicians should consider screening older patients with CKD who have low PA for cognitive impairment and encourage them to meet PA guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfab338","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T15:11:39Z","timestamp":1637593899000},"page":"2180-2189","source":"Crossref","is-referenced-by-count":83,"title":["Chronic kidney disease, physical activity and cognitive function in older adults\u2014results from the National Health and Nutrition Examination Survey (2011\u20132014)"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-3589","authenticated-orcid":false,"given":"Nadia M","family":"Chu","sequence":"first","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indranil","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Heartlands Hospital Birmingham and Warwick Medical School, University of Warwick, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Bohm","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Manitoba , Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorry L","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3013-925X","authenticated-orcid":false,"given":"Mara A","family":"McAdams-DeMarco","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine , Baltimore, MD, USA"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Global Renal Exercise Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,25]]},"reference":[{"key":"2022102109172755700_bib1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.2215\/CJN.02660310","article-title":"Vascular risk factors and cognitive impairment in chronic kidney disease: the Chronic Renal Insufficiency Cohort (CRIC) study","volume":"6","author":"Kurella Tamura","year":"2011","journal-title":"Clin J Am Soc 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