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Neighborhood disadvantage links to dementia in kidney failure

Among older dialysis patients, living in highly disadvantaged neighborhoods was linked to adjusted hazard ratios of 1.09 for dementia and 1.25 for Alzheimer's disease.

Figure 1. Residential neighborhood disadvantage and time to (A) dementia diagnosis and (B) Alzheimer's disease diagnosis among older patients (aged ≥ 55) with kidney failure initiating dialysis (2003-2021). — Figure 1. Residential neighborhood disadvantage and time to (A) dementia diagnosis and (B) Alzheimer's disease diagnosis among older patients (aged ≥ 55) with kidney…Residential neighborhood disadvantage and time to (A) dementia diagnosis and (B) Alzheimer's disease diagnosis among older patients (aged ≥ 55) with kidney failure initiating dialysis (2003-2021).Li et al.

Kidney Medicine4 Oct 2026, 07:29 BST

Older patients aged 55 and older who began dialysis between 2003 and 2021 were evaluated using United States Renal Data System records. Researchers measured neighborhood disadvantage with a ZIP-code index across nine domains and tracked Alzheimer's disease and related dementias via diagnosis codes. Patients in high-disadvantage neighborhoods had higher risks of dementia (adjusted hazard ratio 1.09) and Alzheimer's disease (adjusted hazard ratio 1.25) than those in low-disadvantage neighborhoods. These patterns varied across race, ethnicity, and urbanicity. Older Black patients in high-disadvantage areas had adjusted hazard ratios of 1.19 for dementia and 1.31 for Alzheimer's disease versus those in low-disadvantage settings. Higher risks also appeared in disadvantaged suburban, rural, and small-town areas.

Why it matters

The findings show that environmental and structural factors may compound the risk of late-life neurodegenerative disease in older adults experiencing kidney failure.