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Cognitive Scores After Kidney Transplant Tied to Frailty

Cognitive function first improved then declined 1 to 4 years after transplant in frail recipients

FRIDAY, Jan. 25, 2019 (HealthDay News) — Frail kidney transplant recipients have lower cognitive scores than nonfrail recipients four years after transplant, according to a study published online Jan. 24 in the Journal of the American Society of Nephrology.

Nadia M. Chu, Ph.D., M.P.H., from the Johns Hopkins School of Public Health in Baltimore, and colleagues examined pretransplant frailty and cognitive function in adult kidney transplant recipients. The authors examined the potential short- and medium-term effects of frailty on posttransplant cognitive trajectories by measuring cognitive function up to four years after transplant.

The researchers found that 15 percent of the 665 recipients followed for a median of 1.5 years were frail. Compared with nonfrail patients, frail patients had significantly lower pretransplant cognitive scores after adjustment (89.0 versus 90.8 points). Cognitive performance improved significantly three months after transplant for both frail and nonfrail recipients (slope, 0.22 and 0.14 points/week, respectively). Improvements plateaued among nonfrail recipients between one and four years after transplant (slope, 0.005 points/week), while among frail recipients, cognitive function declined (slope, −0.04 points/week). Cognitive scores were 5.8 points lower for frail versus nonfrail recipients four years after transplant.

“Clinicians may consider regularly monitoring cognitive function and mitigating cognitive decline among frail recipients as part of clinical practice for kidney transplant candidates to prevent cognitive impairment and dementia — a state of chronic and severe cognitive impairment more common among kidney transplant recipients aged 55+ years than older adults generally,” the authors write.

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