Association of AKI With Dementia

Building on previous research suggesting that AKI leads to changes in the brain, Hong Xu, PhD, and colleagues examined the association between AKI and subsequent dementia risk. Their study centered on 305,122 patients aged 65 years and older in Stockholm, Sweden, from 2006 to 2019, none of whom had a dementia diagnosis. The median age was 75±8 years, and 56.6% were women. Median follow-up was 12.3 years (IQR, 8.7-13.3). 

The study exposure was an AKI episode, and the outcome was all-cause dementia and specific types of dementia. Cox proportional hazard regression was used to study the associations between dementia and AKI, the severity of AKI, AKI recurrence, and setting (community-acquired vs hospital-acquired AKI). 

In total, 79,888 patients (26%) had at least one AKI episode. There were 47,938 (16%) incident cases of dementia. The rate of dementia after AKI was 37.0 per 1,000 person-years (95% CI, 36.2-37.8), while the rate observed prior to AKI was 17.3 per 1,000 person-years (95% CI, 17.2-17.5).  

After multivariable adjustment, AKI was associated with a 49% higher rate of subsequent dementia (adjusted HR, 1.49; 95% CI, 1.45-1.53). This pattern was consistent among different types of dementia. Hazard ratios were 1.88 (95% CI, 1.53-2.32) for dementia with Lewy bodies and Parkinson disease with dementia, 1.47 (95% CI, 1.38-1.56) for vascular dementia, and 1.31 (95% CI, 1.25-1.38) for Alzheimer dementia. The associations with dementia risk were stronger in more severe AKI and in hospital-acquired AKI compared to community-acquired AKI. 

In summary, patients who experienced an AKI had a greater risk of being diagnosed with dementia after the AKI incident. 

Source: Neurology