Environmental and social injustices impact dementia risk among older adults with end-stage kidney disease: a national registry study.

ABSTRACT:

Background

Racial/ethnic dementia disparities among older adults with end-stage kidney disease (ESKD) are likely driven by environmental and social injustices. We quantified the impact of fine particulate air pollution exposure (PM_2.5; environmental injustice) by racial/ethnic segregation (social injustice) on dementia diagnosis in ESKD.

Methods

We leveraged the US national registry to identify 884 950 older adults (age ≥55 years) who initiated dialysis (2003-2019). Adjusted Cox regression models with shared state-level frailty quantified the adjusted hazard ratio (aHR) of dementia by PM_2.5 concentrations (annualized and matched to older adults' residential ZIP code at dialysis initiation) and by segregation scores (Theil's H method).

Findings

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SUBMITTER: Li Y 

PROVIDER: S-EPMC12550583 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature