Dementia risk increases in older adults after dialysis

New research shows a higher rate of dementia in older adults after initiation of hemodialysis

Older patients on hemodialysis often experience a significant decline in memory and thinking ability while undergoing hemodialysis. This puts them at high risk for developing dementia, a new study has revealed.

The study also found that dementia in dialysis patients is linked with a higher risk of early death. It was published in the Clinical Journal of the American Society of Nephrology (CJASN).

Mara McAdams-DeMarco, PhD at Johns Hopkins Bloomberg School of Public Health and her colleagues analyzed information on 356,668 US hemodialysis patients of average age of 66 years.

Dementia is an umbrella term used to describe a wide range of symptoms including a decline in memory, thinking, attention, poor judgment and reasoning with change in behaviour and communication skills. Alzheimer’s disease is the most common form of dementia accounting for 60-80% of all cases of dementia.

India has more than 4 million people suffering from some form of dementia and Alzheimer’s account for about 1.6 million cases

According to WHO, worldwide there are about 50 million people living with dementia and about 10 million new cases are added every year. India has more than 4 million people suffering from some form of dementia and Alzheimer’s account for about 1.6 million cases. Alarmingly, this number is set to triple by 2050, according to a Alzheimer’s Disease International (ADI) report.

The 1- and 5-year risks of being diagnosed with dementia after initiating hemodialysis were 4.6% and 16% for women and 3.7% and 13% for men. The respective risks of being diagnosed with Alzheimer’s disease were 0.6% and 2.6% for women and 0.4% and 2.0% for men.

According to previous research, the 10-year incidence of dementia is 1.0-1.5% in adults aged 65 years and 7.4-7.6% in adults aged 75 years in general population. In this study, the researchers estimated that the 10-year risk of a post-hemodialysis dementia diagnosis is 19% for patients aged 66-70 years, rising to 28% for those 76-80 years.

The strongest risk factors for dementia and Alzheimer’s disease were age (86 years), black race, female sex, and institutionalization (such as in a nursing home). Also, older hemodialysis patients with a diagnosis of dementia or Alzheimer’s disease had a 2-fold higher risk of dying.

“We wanted to shed light on the high burden of diagnosed dementia in older patients with kidney failure who initiate hemodialysis,” said Dr. McAdams-DeMarco. “While we were able to study diagnosed dementia, there is a great need to also identify patients with mild cognitive impairment as well as undiagnosed dementia.”