Breaking News
August 21, 2018 - National Foundation for Cancer Research receives Safeway Foundation grant
August 21, 2018 - Protein aggregation in neurons linked to gene regulation in Huntington’s disease
August 21, 2018 - Aravive Biologics gains Fast Track Designation for AVB-S6-500 from U.S. FDA
August 21, 2018 - FDA Approves Opdivo (nivolumab) for Certain Patients with Previously Treated Small Cell Lung Cancer
August 21, 2018 - Success of blood test for autism affirmed
August 21, 2018 - Diabetic patients with disrupted sleep may need more time to heal their wounds
August 21, 2018 - AADE honors six educators for achievements in diabetes education
August 21, 2018 - Scientists find two molecules that may combat cancer and chronic infections
August 21, 2018 - Two Strategies for Preventing Diabetes in Minority Patients
August 21, 2018 - Living as a Gallbladder Cancer Survivor
August 21, 2018 - Can we predict the long-term outcome of boys with ADHD?
August 21, 2018 - GBCA creates model for developing scientist-advocate collaborations in cancer research
August 21, 2018 - Healthy diet could help promote healthy cellular aging in women
August 21, 2018 - Researchers develop gene expression predictor for immunotherapy response in melanoma
August 21, 2018 - MDI Biological Laboratory introduces Morris Scientific Discovery Fund for eligible research programs
August 21, 2018 - Micro-flow model reveals complex interactions between the brain’s blood vessels and nerve cells
August 21, 2018 - Study investigates impact of osteoporosis on risk of developing dementia
August 21, 2018 - Federal method fails to detect most stores that sell cigarettes to minors
August 21, 2018 - Workers in open office seating have less stress than those in private offices and cubicles
August 21, 2018 - 1 in 4 in U.S. Has a Disability, CDC Reports
August 21, 2018 - Studies provide new insights into the role of sleep in chronic pain
August 21, 2018 - Study shows that rogue proteins may underlie some ALS and frontotemporal dementia cases
August 21, 2018 - Elevated LDL cholesterol levels linked to higher risk of CVD death in young, healthy people
August 21, 2018 - Measles cases on the rise in Europe
August 21, 2018 - CURE Media Group welcomes CancerCare to Strategic Alliance Partnership Program
August 21, 2018 - Blood management program associated with fewer transfusions in orthopedic patients
August 21, 2018 - Researchers create the world’s first artificial retina
August 21, 2018 - Yale researchers identify racial disparities in prescribing opioids for chronic pain
August 21, 2018 - BOOST-3 clinical trial aims to improve outcomes for severe TBI patients
August 21, 2018 - New study highlights Alzheimer’s herpes link, experts say
August 21, 2018 - Airline crew don’t have significantly elevated risk of thyroid cancer, new study finds
August 21, 2018 - States leverage federal funds to help insurers lower premiums
August 21, 2018 - New badge course explores research around skeletal muscle as an endocrine organ
August 21, 2018 - TG Therapeutics Announces Completion of Target Enrollment in the ULTIMATE Phase 3 Trials in Multiple Sclerosis
August 21, 2018 - Increased levels of human herpesvirus ID’d in Alzheimer’s
August 21, 2018 - To help patients quash pain, researcher develops practical guide for health care providers
August 20, 2018 - Medicine on the front line to be presented at Medical Innovation 2018
August 20, 2018 - Harbour Biomed and Kelun-Biotech collaborate to develop, commercialize anti-PD-L1 antibody
August 20, 2018 - The man who sold America on vitamin D — and profited in the process
August 20, 2018 - Finding the light in antimicrobials
August 20, 2018 - Unique pain program helps surgical patients wean off opioids safely and effectively
August 20, 2018 - Strawberries could mitigate colonic inflammation
August 20, 2018 - FDA Accepts New Drug Application (NDA) to Review Midazolam Nasal Spray, an Investigational Product for the Acute Treatment of Seizure Clusters
August 20, 2018 - Using Facebook to help young adults quit smoking
August 20, 2018 - ‘Liquid biopsy’ predicts lymphoma therapy success within days | News Center
August 20, 2018 - 5 Questions with Jordan Orange, Chair of Pediatrics
August 20, 2018 - New assay may help improve both sarcoma diagnosis and treatment
August 20, 2018 - New information on the brain regions related to metacognition, tactile sense
August 20, 2018 - New class of insect repellents to fight against mosquito-borne diseases
August 20, 2018 - ACA Coverage Gains Include Workers Without Insurance
August 20, 2018 - 3-D printed biomaterials for bone tissue engineering
August 20, 2018 - Current surveillance system does not quickly pick up most listeriosis cases in the EU, study reveals
August 20, 2018 - Prenatal exposure to acute stress can affect cognitive function in children of low-income households
August 20, 2018 - New study examines scope of state policies targeting drug use by pregnant women
August 20, 2018 - Researchers find long-term structural, functional brain abnormalities in individuals with AUDs
August 20, 2018 - Shortage of insurance fraud cops sparks campaign debate
August 20, 2018 - Researchers find STAT3 as therapeutic target for chronic active EBV infection
August 20, 2018 - Health Tip: Keep Diabetic Feet Healthier
August 20, 2018 - FDA approves brain stimulation device for OCD
August 20, 2018 - NYU Langone’s Perlmutter Cancer Center expands Blood and Marrow Transplant Program
August 20, 2018 - New drug shows potential to prevent painful side effect of therapy
August 20, 2018 - RDMD raises $3 million in seed funding to accelerate rare disease research, drug development
August 20, 2018 - Illicit drug use is higher during celebratory events, may be worse than previously thought
August 20, 2018 - Exploring the relationship between fever and cancer incidence
August 20, 2018 - Study reveals how socioeconomic status affects racial, ethnic disparities in childhood cancer survival
August 20, 2018 - Brain tumors trap immune cells needed to fight cancer in the bone marrow, finds research
August 20, 2018 - Three factors that contribute to physician burnout
August 20, 2018 - Babies dependent on opioids need touch, not tech
August 20, 2018 - Understanding How Antibodies Shape the Gut Microbiome
August 20, 2018 - Cara Therapeutics Doses First Patient in Second Pivotal Phase 3 Efficacy Trial of Korsuva (CR845/difelikefalin) Injection in Hemodialysis Patients with Chronic Kidney Disease-Associated Pruritus
August 20, 2018 - Kidney transplant chains more effective in saving lives
August 20, 2018 - Study unravels cellular and molecular mechanisms behind dermal condensate formation
August 20, 2018 - New integrated gene logic-chips could have great value in medical care
August 20, 2018 - FDA Advisory Committee Recommends Approval of Paratek’s Omadacycline
August 20, 2018 - Total, open repairs decline for abdominal aortic aneurysms
August 20, 2018 - Novel system can pinpoint ingestible implants inside the body using wireless signals
August 20, 2018 - Infection rates of high risk oral HPV in England found to be lower than expected
August 20, 2018 - Making robots as valuable and trustworthy assistants for medical therapies
August 20, 2018 - Patients with low-risk blood clots can be better treated at home than at hospital
August 20, 2018 - Passive smoking exposure among kids greatly increases COPD risk late in life
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