Abstract 4370589: Exercise Induced Improvement in Cognition is Associated with Improved Pulse Wave Velocity in Older Adults with Kidney Disease

Introduction: Older patients with chronic kidney disease (CKD) are at high risk of cognitive impairment. We have previously demonstrated that a 6-month home-based exercise training program improves cognition in older adults with CKD and mild cognitive impairment. Research Questions: 1) What is the impact of a 6-month home-based exercise compared to usual care on arterial stiffness measures? 2) What is the association between changes in arterial stiffness and cognition? Hypothesis: An increased pulse wave velocity will be significantly associated with lower cognitive performance. Methods: Participants (n=32, mean age of 68.4 (5.0) years; 65.6% women, 71.9% Black) were randomized to intervention or usual care. The intervention included a wearable activity monitor, weekly didactic phone meetings, interactive tools (e.g., reminders), and monthly coach-delivered feedback. Carotid-femoral pulse wave velocity was obtained via the Sphygmocor. Results: The compliance rate was 78%, the mean minutes of exercise per week was 174 (155) minutes/week. ANCOVA adjusting for baseline, sex, and age indicating an improvement in PWV in the intervention group of -.20 m/s versus +.41 in the control with a mean difference of -.61 m/s (95% IC -1.2 to .006, p=.05). The effect size was large at η 2 =.14. PWV was strongly correlated with improved global cognition at 6-months (r=-.52, p=.04), learning and memory (r=-.55, p =.03) in the intervention group, but not in the control group. Conclusion: These findings suggest that the observed improvement in cognition following exercise training may be related to an improvement in arterial stiffness providing insight into potential mechanisms of the vascular contribution of improved cognition following exercise training.