Breaking News
December 10, 2018 - People covered by Michigan’s expanded Medicaid program report improvements in health, finds study
December 10, 2018 - Hazelnuts improve micronutrient levels in older adults
December 9, 2018 - History of Partner Violence Tied to Menopause Symptoms
December 9, 2018 - Clean Up Safely After a Disaster|Natural Disasters and Severe Weather
December 9, 2018 - Drug wholesalers drove fentanyl’s deadly rise, report concludes
December 9, 2018 - Deprescribing could help manage polypharmacy in older adults
December 9, 2018 - Retraction of article “Joy of cooking too much” from journal
December 9, 2018 - FDA Warns of Rare Stroke Risk With MS Drug Lemtrada (Alemtuzumab)
December 9, 2018 - Feds say heroin, fentanyl remain biggest drug threat to US
December 9, 2018 - Eliminating microglia can reverse some aspects of stress sensitization, study shows
December 9, 2018 - New genetic insight could help treat rare debilitating heart and lung condition
December 9, 2018 - MiRagen Therapeutics Announces Final Safety, Biodistribution and Clinical Efficacy Data From Phase 1 Cobomarsen Clinical Trial in Patients With Mycosis Fungoides
December 9, 2018 - Work with your doctor to weigh pros, cons of treatment options for hyperthyroidism
December 9, 2018 - CWRU researcher secures $14.6 million funding for genetic study into Alzheimer’s disease
December 9, 2018 - High intensity statin treatment and adherence could save more lives
December 9, 2018 - Surgery patients use only 1/4 of prescribed opioids, and prescription size matters
December 9, 2018 - AXT offers Phi Optics upgrade to QPI systems for inverted light microscopes
December 9, 2018 - New booklet could help improve conditions of young pupils with albinism
December 9, 2018 - Few Physicians Work in Practices That Use Telemedicine
December 9, 2018 - Older Adults and Oral Health
December 9, 2018 - Health utility values improve after septorhinoplasty
December 9, 2018 - New EU-funded project provides insight into how the brain develops
December 9, 2018 - Expanded use of tele-emergency services can help strengthen rural hospitals
December 9, 2018 - Infections in the Young May Be Tied to Risk for Mental Illness: Study
December 9, 2018 - Profile: Native Hawaiians and Pacific Islanders
December 9, 2018 - Snoring poses greater cardiac risk to women
December 9, 2018 - Researcher takes further steps in understanding how and why cute aggression occurs
December 9, 2018 - Researchers create new light-activated tools for controlling neurons
December 9, 2018 - Spinal cord injury disrupts the body’s internal clock, study shows
December 9, 2018 - Babies recognize nested structures similar to our grammar
December 9, 2018 - UT Austin researcher receives $2.5 million CZI grant for neurodegenerative disease research
December 9, 2018 - Sleep problems found to be prevalent and increasing among college students
December 9, 2018 - Study reveals why some children are susceptible to the effects of maltreatment
December 9, 2018 - Study investigates influence of different opioids on driving performance
December 9, 2018 - Jazz Pharmaceuticals Announces First Patient Enrolled in Phase 3 Clinical Trial Evaluating JZP-258 for the Treatment of Idiopathic Hypersomnia
December 9, 2018 - Eliminating microglia prevents heightened immune sensitivity after stress
December 9, 2018 - Boys with social difficulties are at greatest risk of early substance use
December 9, 2018 - ‘Wrong’ connective tissue cells linked to worse prognosis in breast cancer patients
December 8, 2018 - Chronic, refractory schizophrenia patients benefit from targeted cognitive training
December 8, 2018 - Advertising in kids’ apps more prevalent than parents may realize
December 8, 2018 - New way to trace the transmission histories of rare genetic diseases
December 8, 2018 - ASH: A+CHP Bests CHOP for Peripheral T-Cell Lymphoma
December 8, 2018 - Results of pediatric genomic epilepsy tests often reclassified
December 8, 2018 - New way of controlling HIV latency to completely eradicate the virus
December 8, 2018 - Phasefocus to showcase the Livecyte 2 at ASCB
December 8, 2018 - KHN’s ‘What the Health?’ Is health spending the next big political issue?
December 8, 2018 - Mussels take in microplastic pollution fibers and flush most of them out again
December 8, 2018 - AHA: How to Stop Smoking … for Good
December 8, 2018 - Scientists overturn odds to make Parkinson’s discovery
December 8, 2018 - Health benefits of producing marula vinegar
December 8, 2018 - Failure of critical cellular energy sensor responsible for CKD progression, study finds
December 8, 2018 - Ethnicity can be reliable indicator of gut microbiota diversity
December 8, 2018 - Safe Sleep for Baby | NIH News in Health
December 8, 2018 - Study looks at ways technology can support nutritional needs of Parkinson’s patients
December 8, 2018 - Infant milk allergy is being overdiagnosed say experts
December 8, 2018 - Graphene may one day be used to test for ALS
December 8, 2018 - Houston Methodist launches real-time website to track flu cases
December 8, 2018 - RedHill Announces Positive Top-Line Results from Confirmatory Phase 3 Study with Talicia for H. pylori Infection
December 8, 2018 - A way to measure obesity and health beyond BMI
December 8, 2018 - New diagnostic tools may help identify breast cancer patients who could benefit from targeted therapies
December 8, 2018 - Duke-NUS researchers highlight possible role of bioaerosol sampling in pandemic surveillance
December 8, 2018 - Study quantifies links between alcohol, drug use and violent deaths
December 8, 2018 - Mothers’ stress levels at conception linked to child’s response to life challenges at age 11
December 8, 2018 - MIT researchers develop antimicrobial peptides from South American wasp’s venom
December 8, 2018 - Obesity prevention among low-income, diverse preschool-aged children and parents
December 8, 2018 - Mount Sinai researcher awarded $2.5 million to advance understanding of neurodegenerative diseases
December 8, 2018 - CZI announces funding for open-source software efforts to improve image analysis in biomedicine
December 8, 2018 - New book encompasses the vast history of reproduction
December 8, 2018 - Low-income women in Texas are not receiving contraception after childbirth, study shows
December 8, 2018 - Study expands knowledge about sexuality and gender gaps in political attitudes
December 8, 2018 - Drug reduces hot flash frequency, improves quality of life in breast cancer survivors
December 8, 2018 - Imaging, Biopsy Often Still Needed After Mastectomy
December 8, 2018 - Physical Activity Guidelines for Americans: 2nd edition
December 8, 2018 - Machine learning can improve chemical toxicity prediction
December 8, 2018 - Researchers explore why and how Mediterranean diet may mitigate cardiovascular risk
December 8, 2018 - Multigene test is a helpful decision making tool in breast cancer treatment, study shows
December 8, 2018 - New EZ-2 centrifugal evaporator to safely remove solvents from cytotoxic drug preparations
December 8, 2018 - UMGCCC uses Gammapod radiotherapy to treat breast cancer patients
December 8, 2018 - Men with inflammatory bowel disease have higher prostate cancer risk
December 8, 2018 - Newly developed molecules may provide more reliable relief for people with autoimmune diseases
Older kidney disease patients on dialysis have higher dementia risk

Older kidney disease patients on dialysis have higher dementia risk

image_pdfDownload PDFimage_print

Older kidney disease patients who are sick enough to require the blood-filtering treatment known as dialysis are at high risk of dementia, including Alzheimer’s disease, according to a study led by scientists at Johns Hopkins Bloomberg School of Public Health.

The study, published Aug. 9 in the Clinical Journal of the American Society for Nephrology, found evidence that older kidney disease patients had a substantially higher risk of being diagnosed with dementia than community-dwelling older adults.

“The dementia risk in this population seems to be much higher than what we see among healthy community-dwelling older adults,” says study lead author Mara McAdams-DeMarco, assistant professor of epidemiology at the Bloomberg School.

To McAdams-DeMarco and her colleagues, the findings suggest that doctors should be doing more to monitor, and if possible to slow or prevent, cognitive decline among older dialysis patients. “The high incidence of dementia seems to be overlooked in this population,” she says.

Cognitive decline and dementia, including Alzheimer’s disease, are principally age-related and relatively common in the elderly. However, research suggests that kidney disease appears to worsen the problem. Studies over the past two decades have found evidence that as kidney function declines, cognitive functions are apt to decline as well. One recent study in dialysis patients found that this kidney-related cognitive decline was particularly noticeable for executive functions such as attention, impulse control and working memory.

The precise biological mechanism linking kidney disease to brain problems isn’t yet clear, but kidney disease has itself been linked to poor blood flow in the brain, so researchers suspect that as a key factor.

To get a better understanding of the dementia problem among elderly patients with advanced kidney disease, McAdams-DeMarco and colleagues examined a large national kidney disease registry, focusing on 356,668 Medicare patients older than 66 years who had initiated dialysis due to end-stage kidney disease during 2001–2013.

Their analysis was aimed mainly at estimating the risk of a dementia diagnosis within a given period after initiating dialysis. For the female patients in this group, the estimated risk was 4.6 percent for a dementia diagnosis within a year, 16 percent within 5 years, and 22 percent-;a nearly one in four chance-;within 10 years. For males, the corresponding figures were slightly lower at 3.7, 13 and 19 percent.

Alzheimer’s disease represented a significant proportion of dementia diagnoses: The one-year risk of this form of dementia was 0.6 percent for women and 0.4 percent for men.

The study was not designed to compare dialysis patients directly to healthy people of the same age; even so, the dementia risk among these patients was considerably higher than what would be expected in this age group. For example, a well-known prior study following residents of a Massachusetts town found that community-dwelling 65-year-olds had only a 1.0 to 1.5 percent incidence of dementia within 10 years, while for 75-year-olds the incidence was only about 7.5 percent. By contrast, in this study the researchers determined that the 10-year risk of dementia after starting dialysis was 19 percent for patients in the sample aged 66 to 70, and 28 percent among 76- to 80-year-olds.

Even the Alzheimer’s disease risk among the dialysis patients seemed higher than normal-;for example, 4.3 percent of the 66–70-year-olds were diagnosed with the disease within 10 years of starting dialysis, compared to a 10-year incidence of less than 1 percent among 65-year-olds in the Massachusetts study. That suggests that older patients with end-stage kidney disease may even be vulnerable to Alzheimer’s disease.

McAdams-DeMarco and colleagues also found that older dialysis patients with a dementia diagnosis were about twice as likely to die at any time in the study period, compared to older dialysis patients without a dementia diagnosis.

As stark as these findings are, they may understate the problem. “We know from other studies that only about half of patients with dementia receive a diagnosis, so the figures in this study could be seen as a lower limit,” McAdams-DeMarco says.

She and her colleagues suggest that more in-depth studies need to be done to gauge the true extent of the dementia problem among older end-stage kidney disease patients. “Patients starting dialysis generally meet with health care providers a few times per week, so in principle there is ample opportunity to do at least brief cognitive screening,” she says.

She also recommends more studies of potential measures to prevent dementia among these vulnerable patients. “We’re currently setting up a large clinical trial to identify appropriate interventions to preserve cognitive function in these patients,” McAdams-DeMarco says.

Source:

https://www.jhsph.edu/news/news-releases/2018/elderly-patients-on-dialysis-have-a-high-risk-of-dementia.html

Tagged with:

About author

Related Articles