Kidney disease and risk of dementia: a Danish nationwide cohort study
Open Access
- 22 October 2021
- Vol. 11 (10), e052652
- https://doi.org/10.1136/bmjopen-2021-052652
Abstract
Objectives It is unclear whether kidney disease is a risk factor for developing dementia. We examined the association between kidney disease and risk of future dementia. Design and setting Nationwide historical registry-based cohort study in Denmark based on data from 1 January 1995 until 31 December 2016. Participants All patients diagnosed with kidney disease and matched general population cohort without kidney disease (matched 1:5 on age, sex and year of kidney disease diagnosis). Primary and secondary outcome measures All-cause dementia and its subtypes: Alzheimer’s disease, vascular dementia and other specified or unspecified dementia. We computed 5-year cumulative incidences (risk) and hazard ratios (HRs) for outcomes using Cox regression analyses. Results The study cohort comprised 82 690 patients with kidney disease and 413 405 individuals from the general population. Five-year and ten-year mortality rates were twice as high in patients with kidney disease compared with the general population. The 5-year risk for all-cause dementia was 2.90% (95% confidence interval: 2.78% to 3.08%) in patients with kidney disease and 2.98% (2.92% to 3.04%) in the general population. Compared with the general population, the adjusted HRs for all-cause dementia in patients with kidney disease were 1.06 (1.00 to 1.12) for the 5-year follow-up and 1.08 (1.03 to 1.12) for the entire study period. Risk estimates for dementia subtypes differed substantially and were lower for Alzheimer’s disease and higher for vascular dementia. Conclusions Patients diagnosed with kidney disease have a modestly increased rate of dementia, mainly driven by vascular dementia. Moreover, patients with kidney disease may be underdiagnosed with dementia due to high mortality and other comorbidities of higher priority.Funding Information
- Lundbeckfonden (R248-2017-521)
- National Institute of Health (P30AG066615)
- Novo Nordisk (N/A)
This publication has 28 references indexed in Scilit:
- Patients with chronic kidney disease are at an elevated risk of dementia: A population-based cohort study in TaiwanBMC Nephrology, 2012
- The projected effect of risk factor reduction on Alzheimer's disease prevalenceThe Lancet Neurology, 2011
- Danish registers on personal labour market affiliationScandinavian Journal of Public Health, 2011
- The Danish Psychiatric Central Research RegisterScandinavian Journal of Public Health, 2011
- The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference reportKidney International, 2011
- The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of PatientsBMC Medical Research Methodology, 2011
- The Hazards of Hazard RatiosEpidemiology, 2010
- Kidney Function Is Related to Cerebral Small Vessel DiseaseStroke, 2008
- Validity of Dementia Diagnoses in the Danish Hospital RegistersDementia and Geriatric Cognitive Disorders, 2007
- Identification of Individuals With CKD From Medicare Claims Data: A Validation StudyAmerican Journal of Kidney Diseases, 2005