{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T08:05:21Z","timestamp":1778054721833,"version":"3.51.4"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sichuan\u00a0Applied\u00a0Psychology\u00a0Research\u00a0Center","award":["CSXL-202B11"],"award-info":[{"award-number":["CSXL-202B11"]}]},{"DOI":"10.13039\/501100020207","name":"Health Commission of Sichuan Province","doi-asserted-by":"publisher","award":["20PJ172"],"award-info":[{"award-number":["20PJ172"]}],"id":[{"id":"10.13039\/501100020207","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>High-fiber diet has been associated with better cognitive performance. However, the association between dietary fiber intake and cognition in older patients with chronic kidney disease (CKD) remains unknown. Hence, this study aimed to investigate the effect of dietary fiber intake on cognition in older patients with CKD.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study included participants aged \u226560 years who provided data on social demography, cognitive tests (Consortium to Establish a Registry for Alzheimer\u2019s disease Word Learning [CERAD-WL], CERAD Delayed Recall [CERAD-DR], Animal Fluency Test [AFT], and Digit Symbol Substitution Test [DSST]), diet, and other potential cognition-related variables from the National Health and Nutrition Examination Survey 2011\u20132014. Fully-adjusted multivariate logistic regression subgroup models were performed, and multiple linear regression analyses were employed to examine the association between dietary fiber intake and cognition in patients with CKD.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 2461 older adults were included, with 32% who suffered from CKD. Participants with CKD scored lower in CERAD-WL, CERAD-DR, AFT, and DSST. Patients with CKD consuming low dietary fiber (\u226425 g\/day) had a higher risk of CERAD-WL and DSST impairments. High dietary fiber intake eliminated the differences in CERAD-WL and DSST impairments between the CKD and non-CKD participants. However, no associations were observed between CKD and CERAD-DR and AFT impairments regardless of dietary fiber intake. A positive linear relationship between dietary fiber intake and AFT score was observed in older patients with CKD.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>High dietary fiber intake may benefit cognitive function in older patients with CKD. High-fiber diet management strategies could potentially mitigate cognitive impairment in this group of patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0291690","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T17:27:42Z","timestamp":1696440462000},"page":"e0291690","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Dietary fiber intake and cognitive impairment in older patients with chronic kidney disease in the United States: A cross-sectional study"],"prefix":"10.1371","volume":"18","author":[{"given":"Feiyan","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongxi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Mao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1702-3500","authenticated-orcid":true,"given":"Hong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,10,4]]},"reference":[{"issue":"10302","key":"pone.0291690.ref001","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/S0140-6736(21)00519-5","article-title":"Chronic kidney disease","volume":"398","author":"K Kalantar-Zadeh","year":"2021","journal-title":"Lancet"},{"issue":"6","key":"pone.0291690.ref002","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1038\/nrneph.2017.52","article-title":"The systemic nature of CKD","volume":"13","author":"C Zoccali","year":"2017","journal-title":"Nat Rev Nephrol"},{"issue":"8","key":"pone.0291690.ref003","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/s41581-020-0266-9","article-title":"Mechanisms of cognitive dysfunction in CKD","volume":"16","author":"D Viggiano","year":"2020","journal-title":"Nat Rev Nephrol"},{"issue":"1","key":"pone.0291690.ref004","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1017\/S1355617718000917","article-title":"A Systematic Review of Cognitive Impairments Associated With Kidney Failure in Adults Before Natural Age-Related Changes","volume":"25","author":"J Brodski","year":"2019","journal-title":"J Int Neuropsychol Soc"},{"issue":"10","key":"pone.0291690.ref005","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1093\/ckj\/sfac151","article-title":"Ageing meets kidney disease","volume":"15","author":"A Ortiz","year":"2022","journal-title":"Clin Kidney J"},{"issue":"2","key":"pone.0291690.ref006","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1053\/j.ajkd.2016.04.017","article-title":"Estimated GFR, Albuminuria, and Cognitive Performance: The Maastricht Study","volume":"69","author":"RJ Martens","year":"2017","journal-title":"Am J Kidney Dis"},{"issue":"3","key":"pone.0291690.ref007","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1053\/j.ajkd.2017.04.021","article-title":"Cognitive Function and Kidney Disease: Baseline Data From the Systolic Blood Pressure Intervention Trial (SPRINT)","volume":"70","author":"DE Weiner","year":"2017","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"pone.0291690.ref008","doi-asserted-by":"crossref","first-page":"afab259","DOI":"10.1093\/ageing\/afab259","article-title":"Association between kidney function and incidence of dementia: 10-year follow-up of the Whitehall II cohort study","volume":"51","author":"A Singh-Manoux","year":"2022","journal-title":"Age Ageing"},{"issue":"1","key":"pone.0291690.ref009","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1159\/000329097","article-title":"Relationship between uric acid and subtle cognitive dysfunction in chronic kidney disease","volume":"34","author":"B Afsar","year":"2011","journal-title":"Am J Nephrol"},{"issue":"2","key":"pone.0291690.ref010","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/jorc.12393","article-title":"A cross-sectional study exploring cognitive impairment in kidney failure","volume":"48","author":"P Nicholas","year":"2022","journal-title":"J Ren Care"},{"issue":"4","key":"pone.0291690.ref011","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1176\/appi.neuropsych.18030047","article-title":"Cognitive Impairments and Dysexecutive Behavioral Disorders in Chronic Kidney Disease","volume":"30","author":"L Puy","year":"2018","journal-title":"J Neuropsychiatry Clin Neurosci"},{"issue":"1","key":"pone.0291690.ref012","first-page":"10","article-title":"Mild cognitive impairment and kidney disease: clinical aspects","volume":"35","author":"D Viggiano","year":"2020","journal-title":"Nephrol Dial Transplant"},{"issue":"2","key":"pone.0291690.ref013","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s12603-020-1317-4","article-title":"Association between Dietary Protein Intake and Cognitive Function in Adults Aged 60 Years and Older","volume":"24","author":"Y Li","year":"2020","journal-title":"J Nutr Health Aging"},{"key":"pone.0291690.ref014","doi-asserted-by":"crossref","first-page":"991007","DOI":"10.3389\/fnagi.2022.991007","article-title":"The association of diet carbohydrates consumption with cognitive function among US older adults modification by daily fasting duration","volume":"14","author":"S Zhao","year":"2022","journal-title":"Front Aging Neurosci"},{"issue":"1","key":"pone.0291690.ref015","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/s40168-021-01172-0","article-title":"A fiber-deprived diet causes cognitive impairment and hippocampal microglia-mediated synaptic loss through the gut microbiota and metabolites","volume":"9","author":"H Shi","year":"2021","journal-title":"Microbiome"},{"issue":"8","key":"pone.0291690.ref016","doi-asserted-by":"crossref","first-page":"e257","DOI":"10.1016\/j.amjmed.2022.03.022","article-title":"Dietary Fiber Intake is Associated with Cognitive Function in Older Adults: Data from the National Health and Nutrition Examination Survey","volume":"135","author":"K Prokopidis","year":"2022","journal-title":"Am J Med"},{"key":"pone.0291690.ref017","doi-asserted-by":"crossref","first-page":"1024627","DOI":"10.3389\/fnut.2022.1024627","article-title":"Hypertension, dietary fiber intake, and cognitive function in older adults [from the National Health and Nutrition Examination Survey Data (2011\u20132014)]","volume":"9","author":"H Zhang","year":"2022","journal-title":"Front Nutr"},{"issue":"4","key":"pone.0291690.ref018","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1093\/clinchem\/hvab278","article-title":"National Kidney Foundation Laboratory Engagement Working Group Recommendations for Implementing the CKD-EPI 2021 Race-Free Equations for Estimated Glomerular Filtration Rate: Practical Guidance for Clinical Laboratories","volume":"68","author":"WG Miller","year":"2022","journal-title":"Clin Chem"},{"issue":"9","key":"pone.0291690.ref019","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1212\/WNL.39.9.1159","article-title":"The Consortium to Establish a Registry for Alzheimer\u2019s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer\u2019s disease","volume":"39","author":"JC Morris","year":"1989","journal-title":"Neurology"},{"issue":"4","key":"pone.0291690.ref020","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1212\/WNL.62.4.556","article-title":"Diagnostic utility of abbreviated fluency measures in Alzheimer disease and vascular dementia","volume":"62","author":"SJ Canning","year":"2004","journal-title":"Neurology"},{"key":"pone.0291690.ref021","doi-asserted-by":"crossref","first-page":"900887","DOI":"10.3389\/fnut.2022.900887","article-title":"Association of Dietary Vitamin K Intake With Cognition in the Elderly","volume":"9","author":"A Wang","year":"2022","journal-title":"Front Nutr"},{"issue":"6","key":"pone.0291690.ref022","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1093\/ajcn\/nqaa074","article-title":"Effect of chicory inulin-type fructan-containing snack bars on the human gut microbiota in low dietary fiber consumers in a randomized crossover trial","volume":"111","author":"RA Reimer","year":"2020","journal-title":"Am J Clin Nutr"},{"issue":"4","key":"pone.0291690.ref023","doi-asserted-by":"crossref","first-page":"678","DOI":"10.3122\/jabfm.2021.04.210044","article-title":"A Relationship Between Mortality and Eating Breakfast and Fiber","volume":"34","author":"DE King","year":"2021","journal-title":"J Am Board Fam Med"},{"key":"pone.0291690.ref024","doi-asserted-by":"crossref","first-page":"640785","DOI":"10.3389\/fmed.2021.640785","article-title":"Association Between Preadmission Metformin Use and Outcomes in Intensive Care Unit Patients With Sepsis and Type 2 Diabetes: A Cohort Study","volume":"8","author":"Q Yang","year":"2021","journal-title":"Front Med (Lausanne)"},{"issue":"2","key":"pone.0291690.ref025","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1212\/01.wnl.0000225182.15532.40","article-title":"Cognitive impairment in hemodialysis patients is common","volume":"67","author":"AM Murray","year":"2006","journal-title":"Neurology"},{"issue":"3","key":"pone.0291690.ref026","doi-asserted-by":"crossref","first-page":"c247","DOI":"10.1159\/000317206","article-title":"Cognitive profile of chronic kidney disease and hemodialysis patients without dementia","volume":"116","author":"JB Post","year":"2010","journal-title":"Nephron Clin Pract"},{"issue":"2","key":"pone.0291690.ref027","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/j.1532-5415.2009.02670.x","article-title":"Chronic kidney disease and cognitive function in older adults: findings from the chronic renal insufficiency cohort cognitive study","volume":"58","author":"K Yaffe","year":"2010","journal-title":"J Am Geriatr Soc"},{"issue":"4","key":"pone.0291690.ref028","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1097\/WAD.0000000000000178","article-title":"Cognitive Impairment and Dementia in Older Adults With Chronic Kidney Disease: A Review","volume":"30","author":"AR Zammit","year":"2016","journal-title":"Alzheimer Dis Assoc Disord"},{"issue":"7","key":"pone.0291690.ref029","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1681\/ASN.2006101165","article-title":"Moderate chronic kidney disease and cognitive function in adults 20 to 59 years of age: Third National Health and Nutrition Examination Survey (NHANES III)","volume":"18","author":"SM Hailpern","year":"2007","journal-title":"J Am Soc Nephrol"},{"issue":"1","key":"pone.0291690.ref030","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1186\/s12916-016-0745-9","article-title":"Cognition in chronic kidney disease: a systematic review and meta-analysis","volume":"14","author":"I Berger","year":"2016","journal-title":"BMC Med"},{"issue":"6","key":"pone.0291690.ref031","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1053\/j.ajkd.2019.05.017","article-title":"Cognitive Impairment in CKD: Pathophysiology, Management, and Prevention","volume":"74","author":"DA Drew","year":"2019","journal-title":"Am J Kidney Dis"},{"issue":"2","key":"pone.0291690.ref032","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1080\/1028415X.2020.1751506","article-title":"Markers of a plant-based diet relate to memory and executive function in older adults","volume":"25","author":"MM Ramey","year":"2022","journal-title":"Nutr Neurosci"},{"issue":"3","key":"pone.0291690.ref033","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/joim.13333","article-title":"The Mediterranean diet and health: a comprehensive overview","volume":"290","author":"M Guasch-Ferr\u00e9","year":"2021","journal-title":"J Intern Med"},{"issue":"3","key":"pone.0291690.ref034","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.amjmed.2014.10.014","article-title":"The Mediterranean diet, its components, and cardiovascular disease","volume":"128","author":"R Jay Widmer","year":"2015","journal-title":"Am J Med"},{"issue":"11","key":"pone.0291690.ref035","doi-asserted-by":"crossref","first-page":"9139","DOI":"10.3390\/nu7115459","article-title":"Definition of the Mediterranean Diet; a Literature Review","volume":"7","author":"C Davis","year":"2015","journal-title":"Nutrients"},{"issue":"1","key":"pone.0291690.ref036","doi-asserted-by":"crossref","first-page":"11786","DOI":"10.1038\/s41598-021-91259-3","article-title":"Diet and general cognitive ability in the UK Biobank dataset","volume":"11","author":"P Hepsomali","year":"2021","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0291690.ref037","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1038\/s41398-022-01922-0","article-title":"Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders","volume":"12","author":"J Horn","year":"2022","journal-title":"Transl Psychiatry"},{"issue":"8","key":"pone.0291690.ref038","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1038\/s41575-019-0157-3","article-title":"The role of short-chain fatty acids in microbiota-gut-brain communication","volume":"16","author":"B Dalile","year":"2019","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"5","key":"pone.0291690.ref039","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.cmet.2021.02.002","article-title":"High-fiber diet mitigates maternal obesity-induced cognitive and social dysfunction in the offspring via gut-brain axis","volume":"33","author":"X Liu","year":"2021","journal-title":"Cell Metab"},{"issue":"1","key":"pone.0291690.ref040","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s00213-020-05665-y","article-title":"A specific dietary fibre supplementation improves cognitive performance-an exploratory randomised, placebo-controlled, crossover study","volume":"238","author":"K Berding","year":"2021","journal-title":"Psychopharmacology (Berl)"},{"issue":"17","key":"pone.0291690.ref041","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1001\/jama.298.17.2038","article-title":"Prevalence of chronic kidney disease in the United States","volume":"298","author":"J Coresh","year":"2007","journal-title":"JAMA"},{"issue":"19","key":"pone.0291690.ref042","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race","volume":"385","author":"LA Inker","year":"2021","journal-title":"N Engl J Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T17:28:04Z","timestamp":1696440484000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291690"}},"subtitle":[],"editor":[{"given":"Yee Gary","family":"Ang","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,10,4]]},"references-count":42,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0291690","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,4]]}}}