Cognitive Function, Physical Inactivity and Vascular Function in Older Adults with Chronic Kidney Disease

Introduction: Chronic kidney disease (CKD) is a common disease in older adults that is associated with numerous complications, including cognitive impairment and vascular dysfunction. Additionally, older adults have lifestyle factors that can negatively influence their health, including being sedentary. The purpose of this dissertation was to examine cognitive function, physical inactivity levels, and vascular function in older adults with and without CKD and to explore the relationships between these factors. Additionally, the relationship between cognitive function and vascular compliance and whether level of physical inactivity moderated this relationship was explored. Methods: Utilizing a cross-sectional design, 48 older adults (24 with CKD, 24 without CKD) were evaluated for performance on a cognitive test of global cognition and executive function, vascular compliance via tonometry and ultrasound (carotid compliance and endothelial function), and physical inactivity with actigraphy. Data was analyzed utilizing OLS regression, Pearson’s correlations, and regression moderation analysis. Results: Older adults with CKD had different levels of cognitive impairment, vascular dysfunction, and physical inactivity than older adults without CKD. In regression models including CKD and relevant covariates, the variance of cognitive function, indicators of regional arterial stiffness, some indicators of carotid compliance, and sedentary time per day were significantly explained. With exploration, global cognitive function was found to be significantly correlated with carotid-femoral pulse wave velocity and an indicator of carotid artery compliance. Executive function scores were not found to be significantly correlated with vascular compliance in older adults with CKD. There was exploration into the potential moderating influence of sedentary time on the relationship between vascular compliance and cognitive function in older adults. Conclusion: Cognitive impairment, some indicators of vascular function, and sedentary time appear to be different between older adults with and without CKD. With exploration, there was support of a potential relationship between vascular compliance and global cognitive function. Further investigation is needed into the moderating influence of sedentary time on the relationship between vascular function and cognitive impairment. There is a need for further exploration into the relationships between cognitive function, physical inactivity levels, and vascular function in older adults with and without CKD.