Kidney Week

Abstract: SA-PO0487

Prevalence and Risks of Alzheimer Disease and Related Dementias by Level of Kidney Function in Patients with Diabetes

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Bruce, Marino A., University of Houston, Houston, Texas, United States

Marino A. Bruce, MS, PhD

• Kornowske, Lindsey M., Providence Washington, Seattle, Washington, United States

Lindsey M. Kornowske, MS

• Alicic, Radica Z., Providence Washington, Seattle, Washington, United States

Radica Z. Alicic, MD, MS, FASN

• Beech, Bettina M., University of Houston, Houston, Texas, United States

Bettina M. Beech, DrPH, MPH

• Thorpe, Roland J., Johns Hopkins University, Baltimore, Maryland, United States

Roland J. Thorpe, PhD

• Norris, Keith C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Keith C. Norris, MD, PhD

• Jones, Cami R., Providence Washington, Seattle, Washington, United States

Cami R. Jones, PhD

• Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Susanne B. Nicholas, MD, PhD, MPH

• Daratha, Kenn, Providence Washington, Seattle, Washington, United States

Kenn Daratha, PhD

• Tuttle, Katherine R., Providence Washington, Seattle, Washington, United States

Katherine R. Tuttle, MD, FASN

Background

Diabetes mellitus (DM) increases risks for chronic kidney disease (CKD) and Alzheimer's disease and related dementias (ADRD). The study aim was to determine the prevalence and risks of ADRD by estimated glomerular filtration rate (eGFR) in a large real-world population with DM.

Methods

The Center for Kidney Disease Research, Education, and Hope (CURE-CKD) Registry provided data from the electronic health records (2013-2024) of people with diabetes at Providence Health, a large non-profit health system operating in 7 western states of the United States. ADRD was identified using ≥1 diagnosis code. Kidney function was categorized by creatinine-based eGFR. Multivariable logistic regression estimated odds of ADRD by eGFR levels with adjustment for socio-demographic, clinical, residence, and healthcare utilization variables.

Results

Among 1,482,027 people with DM, 19,597 (1.3%) were diagnosed with ADRD. ADRD prevalence increased with age, from 0.1% among adults <65 years to 10.5% among adults ≥85 years. ADRD prevalence showed a U-shaped relationship with eGFR from 0.5% at ≥90 to 2.1% at 60-89, 3.7% at 45-59, 4.0% at 30-44, 3.2% at 15-29, and 1.4% at <15 mL/min/1.73m². Adjusted odds of ADRD showed a similar pattern (Figure 1) with the highest odds at eGFR 45-59 mL/min/1.73m²

Conclusion

Compared to higher eGFR, levels between 30-89 mL/min/1.73m² associated with higher prevalence and odds of ADRD in a large real-world population with DM. Conversely, ADRD odds trended lower with eGFR <30 mL/min/1.73m², suggesting reverse causality for cognitive capacity to present a survival advantage in CKD. Strategies to improve ADRD and CKD outcomes in DM may include interventions to preserve both kidney function and cognition.

Variables associated with ADRD in patients with diabetes.

Funding

• Other NIH Support