The following is a summary of “Neighborhood Racial and Ethnic Segregation and the Risk of Dementia in Older Adults Living with Kidney Failure,” published in the April 2024 issue of Nephrology by Li et al.

Dementia has a remarkable ability to affect older-minority adults with kidney failure more commonly than others.

Researchers conducted a retrospective study, looking into racial and ethnic segregation as a factor contributing to this disparity in dementia among older adults with kidney failure. 

They found 901,065 older adults (age ≥ 55) with kidney failure from 2003 to 2019 using the United States Renal Data System (USRDS). Dementia risk was measured across different levels of neighborhood segregation score using cause-specific hazard models, considering individual and neighborhood factors—analysis of how segregation affected dementia risk differently based on race and ethnicity. 

The results showed that between the selected duration, a total of 79,851 older adults with kidney failure and dementia were identified after a mean follow-up of 2.2 years. Living in a highly segregated neighborhood raised dementia risk by 1.63 times (95% CI: 1.60-1.66), also varying by race/ethnicity (Asian: 1.26 [1.15-1.38], Black: 1.66 [1.61-1.71], Hispanic: 2.05 [1.93-2.18], White: 1.59 1.55-1.64, P_interaction<0.001). In minority-dominant high-segregation areas, all groups faced higher risks compared to Whites in similar neighborhoods (Asian: 1.76 [1.64-1.89], Black: 2.65 [2.54-2.77], Hispanic: 2.15 [2.04-2.26], and White: 2.20 [2.09-2.31]). Moreover, Dialysis in these areas also increased the risk of dementia (1.53%, 95% CI: 1.50-1.56, P_interaction<0.001).

Investigators concluded that residing or receiving care at centers located in segregated neighborhoods raised dementia risk for older adults with kidney failure, especially minoritized individuals.

Source: journals.lww.com/jasn/abstract/9900/neighborhood_racial_and_ethnic_segregation_and_the.300.aspx