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

The purpose of this study is to see if 6 months of home-based walking will improve memory, and brain structure and function, compared to health education in older adults that have chronic kidney disease and mild cognitive impairment.

Inclusion Criteria:• Diagnosed stage 3-4 chronic kidney disease (CKD, estimated glomerular filtration rate (eGFR) <60 to 20 ml/min);>55 yrs of ageMild cognitive impairment (18-26 on the MOCA)ability to undergo an MRno history of major head trauma (No head trauma/concussion with loss of consciousness)Speaks, reads, writes EnglishExclusion Criteria:• Diagnosed Dementia or a Clinical Dementia Rating Scale score of <2, or a MOCA of <18Participating in a supervised exercise program with intent to increase fitness levels 3 days/week,Requires assistive ambulationLimited exercise capacity due to claudication; unstable angina, severe arthritis, extreme dyspnea on exertion, unstable coronary artery diseaseClass III-IV heart failureHistory of uncontrolled sustained arrhythmias, severe/symptomatic aortic or mitral stenosis, hypertrophic obstructive cardiomyopathy, severe pulmonary hypertension, active myocarditis/pericarditis, thrombophlebitis, and recent systemic/pulmonary embolusResting systolic BP >200 mmHg or resting diastolic BP >110 mmHgAny unforeseen illness or disability that would preclude cognitive testing or exercise trainingOne 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 of enrollment or unstable clinical depression requiring medication adjustment within 3 months of enrollment