Introduction: Patients with chronic kidney disease (CKD) exhibit a higher probability of having cognitive impairment or dementia than those without CKD. The beneficial effects of physical exercise on cognitive function are known in the general older population, but more research is required in older adults with CKD. Methods: Eighty-one outpatients (aged ≥65 years) with CKD stage G3–G4 were assessed for eligibility. Among them, 60 were randomized (single-center, unblinded, and stratified) and 53 received the allocated intervention (exercise n = 27, control n = 26). Patients in the exercise group undertook group-exercise training at our facility once weekly and independent exercises at home twice weekly or more, for 24 weeks. Patients in the control group received general care. General and specific cognitive functions (memory, attention, executive, and verbal) were measured, and differences in their scores at baseline and at the 24-week follow-up visit were assessed between the 2 groups. Results: Forty-four patients completed the follow-up at 24 weeks (exercise n = 23, control n = 21). Patients in the exercise group showed significantly greater changes in Wechsler Memory Scale-Revised Logical Memory delayed recall (exercise effect: 2.82, 95% CI: 0.46–5.19, p = 0.03), and immediate and delayed recall (exercise effect: 5.97, 95% CI: 1.13–10.81, p = 0.02) scores than those in the control group. Conclusions: The 24-week exercise intervention significantly improved the memory function in older adults with pre-dialysis CKD. This randomized controlled trial suggests that physical exercise is a useful nonpharmacological strategy for preventing cognitive decline in these patients.

This study’s objective was to explore the association between various factors and the increased caregiver burden of informal caregivers during the COVID-19 pandemic. On February, 2021, 700 informal caregivers completed an online survey. We assessed the change in caregiver burden during the COVID-19 pandemic. Among all caregiver participants, 287 (41.0%) complained of an increased caregiver burden due to the COVID-19 pandemic. The factors associated with increased caregiver burden were depressive symptoms in caregivers [odds ratio (OR), 2.20; 95% confidence interval (CI), 1.50–3.23], dementia (OR, 2.48; 95%CI, 1.07–5.73) and low Barthel Index scores (OR, 2.01; 95%CI, 1.39–2.90) in care receivers, care days (OR, 1.09; 95%CI, 1.01–1.17) and times (OR, 1.06; 95%CI, 1.01–1.10), and use of home care service (OR, 1.46; 95%CI, 1.01–2.10) and visiting care service (OR, 1.71; 95%CI, 1.20–2.45). These findings suggest we need to pay attention to the physical and mental health of both the care receivers and caregivers.