AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Baseline Gait Speed and Risk of Incident Cognitive Impairment in Adults with Chronic Kidney Disease
By Lash J, Campos S, Missikpode C et al.
Background: Adults with chronic kidney disease (CKD) are at higher risk for physical disability and cognitive impairment. Although slower gait speed has been linked to cognitive decline and dementia in the general population, prospective studies examining this association in adults with CKD are limited. Methods: We investigated 981 Chronic Renal Insufficiency Cohort participants with gait speed assessment as part of the Short Physical Performance Battery [SPPB] and ≥2 follow-up measures of cognitive function without cognitive impairment at study entry. Gait speed scores were categorized as low (0-1), intermediate (2-3) and high (4). Cognitive tests included Modified Mini-Mental (3MS, global cognition); Trails A (attention/processing); Trails B (executive function) and Buschke (verbal memory). Associations between gait speed and incident cognitive impairment (≥1 SD worse than cohort mean) were examined using Cox models. Results: Mean age was 66.0 years, 46.6% were female, 61.8% had diabetes and 40.5% had cardiovascular disease, mean eGFR was 53.7 ml/min/1.73m ² . After median follow-up of 5.3 years, incident cognitive impairment rates per 1000 person-years were 24.4 for global cognition (3MS), 39.2 for attention/processing speed (Trails A), 67.9 executive function (Trails B), and 35.9 for memory (Buschke delayed verbal recall). Compared with participants with high gait speed, those with low gait speed had a higher risk of incident cognitive impairment in global cognition ( Table , HR 2.14, 95% CI 1.10-4.18), attention/processing speed (HR 2.14, 95% CI 1.05-4.37), and verbal memory (HR 2.59, 95% CI 1.15-5.83). Each one-point decrease in gait speed score was associated with higher risk of incident cognitive impairment across these domains. There was no significant association with incident cognitive impairment in executive function (Trails B). Conclusion: Lower gait speed scores were independently associated with a higher risk of incident cognitive impairment across multiple cognitive domains. Gait speed may be a simple, clinically accessible assessment for identifying adults with CKD at higher risk for future cognitive decline.