Accelerated Age-related Cognitive Decline: Impact of Exercise on Executive Function and Neuroplasticity

Inclusion Criteria:

• • Diagnosed stage 3-4 chronic kidney disease (CKD, estimated glomerular filtrationrate (eGFR) <60 to 20 ml/min);

• >55 yrs of age

• Mild cognitive impairment (18-26 on the MOCA)

• ability to undergo an MR

• no history of major head trauma (No head trauma/concussion with loss ofconsciousness)

• Speaks, reads, writes English

Exclusion Criteria:

• • Diagnosed Dementia or a Clinical Dementia Rating Scale score of <2, or a MOCA of <18

• Participating in a supervised exercise program with intent to increase fitnesslevels 3 days/week,

• Requires assistive ambulation

• Limited exercise capacity due to claudication; unstable angina, severearthritis, extreme dyspnea on exertion, unstable coronary artery disease

• Class III-IV heart failure

• History of uncontrolled sustained arrhythmias, severe/symptomatic aortic ormitral stenosis, hypertrophic obstructive cardiomyopathy, severe pulmonaryhypertension, active myocarditis/pericarditis, thrombophlebitis, and recentsystemic/pulmonary embolus

• Resting systolic BP >200 mmHg or resting diastolic BP >110 mmHg

• Any unforeseen illness or disability that would preclude cognitive testing orexercise training

• One or more contraindication for MRI; cardiac pacemaker, aneurysm clip,cochlear implants, shrapnel, history of metal fragments in eyes,neurostimulators, diagnosed claustrophobia (MRI only)

• Any self-reported major psychiatric disorders requiring medical therapy (e.g.schizophrenia, bipolar disorder).

• Self-reported new diagnosis of clinical depression within 3 months ofenrollment or unstable clinical depression requiring medication adjustmentwithin 3 months of enrollment