Patient Activation Impacts Physical Activity in Older Adults with CKD
Bibliographic record
Abstract
Background: Older adults with Stage 3B-5 chronic kidney disease (CKD) experience high mortality due to cardiovascular disease. Though physical activity reduces cardiovascular risk, most older adults with CKD are sedentary. The few physical activity interventions for this group face high drop-out, potentially because they do not target factors that strongly impact activity. We tested whether Patient Activation, a modifiable psychological construct of knowledge, confidence, and skill, associates with physical activity frequency in older adults with CKD to explore its utility as an intervention target. Methods: In a cross-sectional multi-site study, we collected validated psychological (including Patient Activation Measure-13 (PAM-13); 0-100, Levels 1-4) and physiologic (including Montreal Cognitive Assessment, Physical Frailty Phenotype) factors. Physical activity was measured with the first question of the validated Exercise Vital Sign, a report of the average days/week of moderate-to-vigorous physical activity. Comorbidities were obtained from the medical record. Results: In 231 older adults with Stage 3B-5 CKD (median age 69, 46% women, 26% Black), median PAM-13 was 65.50 (Interquartile Range (IQR) [55.60, 75]). Higher Activation associated with more frequent days of moderate-to-vigorous physical activity. Adjusting for demographics, hemoglobin, body mass index, cognition, comorbidities, instrumental support, depression, anxiety, literacy, pain, and fatigue, a 19.4 point, or 1 IQR difference in PAM-13 associated with a 0.83 (95% Confidence Interval (CI) [0.36, 1.31]; p<0.001) increase in activity days. On average, frailty associated with fewer activity days, -1.89 (95% CI [-3.07, -0.71]); p<0.01). Conclusion: Older adults with CKD reporting higher Activation also reported more frequent moderate-to-vigorous physical activity, independent of many conceptually relevant covariates. Funding: NIDDK Support
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".