More advanced kidney disease linked to dementia in older adults
Stages 4 and 5 kidney disease had higher relative dementia risk than stage 3, with adjusted hazard ratios of 1.28 and 1.82, respectively.
Our read
Populations- Studied:
- Cohort study of 211,321 older adults with advanced chronic kidney disease
- What changed:
- Dementia diagnosis risk was higher with stage 5 kidney disease than stage 3 (adjusted hazard ratio 1.82)
- The catch:
- Hypertension and diabetes severity and duration could explain both kidney disease progression and dementia risk
- In the record:
- The 795th paper on chronic kidney disease with results in people; 4,138 on record in all. Its result on dementia agrees with all 9 other findings on record.
Editor of record: Boris Djordjevic · AgingResearch.News
US adults aged 66 or older with newly diagnosed stage 3–5 chronic kidney disease formed an observational cohort of 211,321 people drawn from Medicare records for 2010–2022. Their average age was 77, and 51.7% were female. None had a recorded dementia diagnosis in the preceding two years. Researchers tracked dementia diagnoses as kidney disease stage changed.
Unadjusted five-year estimates of diagnosed dementia were 17.3% at stage 3, 22.5% at stage 4 and 20.8% at stage 5. After adjustment for other factors, stages 4 and 5 remained linked to higher dementia risk than stage 3. The links varied by race and ethnicity and were particularly strong among Black adults. The stage 5 link also varied by neighborhood disadvantage and was stronger in highly disadvantaged neighborhoods.
Why it matters
For cognitive decline in older adults with advanced kidney disease, the authors suggested the findings may help target early detection and management.
Caveats
Dementia diagnoses came from billing codes, which may miss cases or reflect differences in detection; unmeasured health differences could also help account for the links. The findings do not cover people under 66 or those with dementia already recorded at entry.
From the paper
- Participants
We identified 211,321 older adults (aged ≥ 66) with an incident diagnosis of advanced stage (stages 3–5) CKD in the US between January 1, 2010, and December 31, 2022.
- Result
After adjustment, older adults with CKD stage 4 (aHR: 1.28, 95% CI:1.25–1.32) had a higher risk of diagnosed dementia compared with those with CKD stage 3.
Quoted word for word from the full text on PubMed Central.
The paper
Dementia in Advanced Kidney Disease by Race and Ethnicity and Neighborhood Factors
New York University
Kidney International Reports, Jul 28, 2026, Open access
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