{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:01:12Z","timestamp":1747188072071,"version":"3.40.5"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007452","name":"Wu Jieping Medical Foundation","doi-asserted-by":"publisher","award":["320.6750.17073"],"award-info":[{"award-number":["320.6750.17073"]}],"id":[{"id":"10.13039\/100007452","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172552"],"award-info":[{"award-number":["82172552"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients undergoing hemodialysis are highly predisposed to arterial disease, poor physical performance, and cognitive impairment. However, the connection between them is not yet known. We aimed to investigate the mediating effect of physical performance on the relationship between arterial stiffness and mild cognitive impairment (MCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicenter cross\u2010sectional study. The final analyzed hemodialysis patients comprised 616 subjects (men 391, women 225) from seven dialysis units in Shanghai, China. MCI was assessed by Mini\u2010Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scale. Arterial function was measured by ankle\u2010brachial index (ABI) and branchial\u2010ankle pulse\u2010wave velocity (baPWV). Physical function was assessed by the Short Physical Performance Battery (SPPB). Logistic regression and mediation model were used to analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the final analysis sample (<jats:italic>n<\/jats:italic>\u2009=\u2009616) was 59.0\u2009\u00b1\u200912.0\u00a0years. Hemodialysis patients with MCI were more likely to have lower ABI (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and higher baPWV (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). After adjusting for covariates, lower ABI (abnormal \u22640.9 and borderline 0.91\u20130.99) were positively associated with MCI (OR\u2009=\u20094.43, 95% CI\u2009=\u20091.89\u201310.39; OR\u2009=\u20094.83, 95% CI\u2009=\u20091.61\u201314.46). SPPB total score and its components standing balance, gait speed score were negatively associated with MCI. In the mediational model, gait speed played a mediating role (indirect effect ab\u2009=\u2009\u22120.21; 95% CI\u2009=\u2009\u22120.58 to \u22120.03) in the association of ABI (\u22640.9) and MMSE, while standing balance and chair stands did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower gait speed mediates a positive association between ABI and MCI in hemodialysis patients. Suitable interventions for physical performance, especially gait speed, may reduce the risk of MCI in hemodialysis patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sdi.13089","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T08:48:37Z","timestamp":1650876517000},"page":"162-169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Mediating effect of gait speed on the relationship between ankle\u2010brachial index and mild cognitive impairment in hemodialysis patients"],"prefix":"10.1111","volume":"36","author":[{"given":"Yinjiao","family":"Zhao","sequence":"first","affiliation":[{"name":"Jiangwan Hospital of Shanghai Hongkou District Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peiyu","family":"Song","sequence":"additional","affiliation":[{"name":"Jiangwan Hospital of Shanghai Hongkou District Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Jiangwan Hospital of Shanghai Hongkou District Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Shanghai University of Medicine and Health Sciences  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peipei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Shanghai University of Medicine and Health Sciences  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danshu","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weifeng","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Fifth People's Hospital of Shanghai Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiunan","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Nephrology Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Suzhou Kowloon Hospital Shanghai Jiaotong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohua","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Nephrology Zhabei Central Hospital of Jing'an District of Shanghai  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Tongji Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nephrology Shanghai Pudong New Area People's Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fandi","family":"Xie","sequence":"additional","affiliation":[{"name":"Jiangwan Hospital of Shanghai Hongkou District Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital  Shanghai 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