Table 3.
Risk factors for incident diagnosis with dementia and Alzheimer’s disease in older (age ≥66 years old) patients with ESKD initiating hemodialysis
| Risk Factor | Dementia Hazard Ratios (95% CI) | Alzheimer’s Disease Hazard Ratios (95% CI) |
|---|---|---|
| Age, yr | ||
| 66–70 | Reference | Reference |
| 71–75 | 1.31 (1.28 to 1.34) | 1.47 (1.40 to 1.56) |
| 76–80 | 1.59 (1.55 to 1.63) | 1.86 (1.76 to 1.96) |
| 81–85 | 1.91 (1.86 to 1.96) | 2.04 (1.93 to 2.16) |
| ≥86 | 2.11 (2.04 to 2.18) | 2.11 (1.97 to 2.25) |
| Women | 1.10 (1.08 to 1.12) | 1.12 (1.08 to 1.16) |
| Race | ||
| White | Reference | Reference |
| Black | 1.70 (1.67 to 1.73) | 1.78 (1.71 to 1.85) |
| Other/unknown | 1.01 (0.98 to 1.05) | 0.94 (0.87 to 1.02) |
| Hispanic ethnicity | 1.30 (1.26 to 1.33) | 1.75 (1.66 to 1.84) |
| Employment status | ||
| Retired | Reference | Reference |
| Employed | 0.68 (0.63 to 0.74) | 0.68 (0.56 to 0.81) |
| Unemployed | 1.08 (1.05 to 1.11) | 0.99 (0.94 to 1.06) |
| Other | 1.05 (1.02 to 1.07) | 1.08 (1.03 to 1.13) |
| Body mass index, kg/m2 | ||
| <18.5 | 1.29 (1.24 to 1.35) | 1.31 (1.20 to 1.43) |
| 18.5–25.0 | 1.27 (1.24 to 1.29) | 1.35 (1.29 to 1.42) |
| 25.0–30.0 | 1.17 (1.15 to 1.20) | 1.24 (1.19 to 1.30) |
| ≥30.0 | Reference | Reference |
| eGFR<15, ml/min per 1.73 m2 | 1.17 (1.14 to 1.21) | 1.18 (1.11 to 1.26) |
| Cancer | 0.80 (0.78 to 0.82) | 0.81 (0.77 to 0.85) |
| Hypertension | 1.05 (1.02 to 1.08) | 1.13 (1.06 to 1.20) |
| Diabetes | 1.07 (1.05 to 1.08) | 1.05 (1.02 to 1.09) |
| Peripheral vascular disease | 0.88 (0.86 to 0.90) | 0.84 (0.80 to 0.88) |
| Stroke/transient ischemic attack | 1.43 (1.40 to 1.46) | 1.28 (1.22 to 1.34) |
| Atherosclerotic heart disease | 0.90 (0.88 to 0.91) | 0.85 (0.82 to 0.89) |
| Congestive heart failure | 0.86 (0.84 to 0.87) | 0.84 (0.81 to 0.87) |
| Alcohol dependence | 1.06 (0.98 to 1.15) | 0.80 (0.65 to 0.97) |
| Tobacco use | 1.01 (0.98 to 1.04) | 0.96 (0.90 to 1.04) |
| Inability to ambulate | 1.19 (1.15 to 1.22) | 1.08 (1.01 to 1.14) |
| Institutionalized | 1.36 (1.33 to 1.39) | 1.10 (1.05 to 1.15) |
| Activities of daily living assistance | 1.09 (1.07 to 1.11) | 1.12 (1.07 to 1.16) |
| Year of hemodialysis initiation | ||
| 2001–2005 | Reference | Reference |
| 2005–2007 | 1.04 (1.02 to 1.06) | 1.08 (1.04 to 1.13) |
| 2008–2010 | 1.17 (1.14 to 1.19) | 1.05 (1.00 to 1.10) |
| 2011–2013 | 1.31 (1.27 to 1.34) | 0.93 (0.88 to 0.98) |
All hazard ratios are from a single adjusted competing risks survival model for the diagnoses with dementia and Alzheimer’s disease outcomes separately. Alzheimer’s disease is a subtype of dementia; therefore, the patients with Alzheimer’s disease are a subset of the patients with dementia. Dementia and Alzheimer’s disease are International Classification of Disease–reported diagnoses of dementia or Alzheimer’s disease. 95% CI, 95% confidence interval.