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Seniors undergoing hemodialysis at high risk for dementia, Alzheimer’s
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Older patients are at a high risk for developing dementia and Alzheimer’s disease after initiation of hemodialysis, according to new research appearing in the Clinical Journal of the American Society of Nephrology. Researchers also found that dementia in dialysis patients is linked with a higher risk for early death.
“The take-home message is that there is a high burden of diagnosed dementia among older patients undergoing hemodialysis,” Mara McAdams-Demarco, PhD, from Johns Hopkins Bloomberg School of Publish Health, told Healio Nephrology. “These patients are at a twofold increased risk for mortality after a diagnosis with dementia.”
The researchers studied 356,668 patients aged 66 years and older who were on hemodialysis. According to the study, the 1-year and 5-year risk for diagnosed dementia accounting for competing risks were 4.6% and 16% for women and 3.7% and 13% for men. The strongest independent risk factors for diagnosis of dementia and Alzheimer’s disease included age older than 85 years, black race, female sex and institutionalization (such as a nursing home).
According to a press release, previous research suggested that the 10-year incidence for dementia is 1% to 1.5% in adults aged 65 years and 7.4% to 7.6% in adults aged 75 years. Using a similar analytic approach, McAdams-DeMarco and her team estimated that the 10-year risk for a post-hemodialysis dementia diagnosis is 19% for patients aged 66 to 70 years, rising to 28% for those aged 76 to 80 years.
In an accompanying editorial, Judy Weintraub wrote about her personal connection to the field. She had begun dialysis treatment in the mid-70s, and pondered the mortality and morbidity rate given the advancement of technology.
“There is great potential for learning and improvement that can be provided in the hemodialysis setting,” Weintraub said. “And not simply for the dialysis populations but for all the individuals who spend time there.”- by Jake Scott
Disclosures: The authors reported no financial disclosures.
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McAdams-DeMaro M, et al. Clin J Am Soc Nephrolog. 2018;doi:10.2215/CJN.10150917.
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