Work

Frailty and Cognitive Change Among Kidney Transplant Recipients

Year: 2017

Type: article

Abstract: With restoration of kidney function, kidney transplant (KT) recipients may experience preserved or improved cognitive function. However, KT recipients have a higher burden of frailty at the time of KT, and frail recipients may not experience this potential benefit. The goal of this prospective study was to assess post-KT cognitive trajectories by frailty status (12/2008 – 12/2015). Participants completed a physical frailty exam (five Fried criteria) and global cognitive testing (3MS) at time of KT-admission, as well as at least one cognitive follow-up during post-KT. We used a mixed effects model including follow-up time, age, sex, race, donor type, and 3MS score at time of KT as predictors, with a random slope (time) and intercept (person), to describe multiple 3MS scores post-KT by frailty status. Of 625 KT recipients (mean age 53 years) followed for a median of 2.0 years (mean of 3.9 visits), 15.7% were frail with a mean 3MS score of 90.3 at time of KT. In the first month post-KT, non-frail recipients experienced a statistically significant cognitive improvement (0.077 points-per-day, 95% CI: 0.047, 0.11), however there was no evidence of such an improvement among frail recipients (0.017 points-per-day, 95% CI: -0.056, 0.089). In the first three months post-KT, analogous trajectories were observed (non-frail: 1.4 points per month, 95% CI: 0.74, 2.1; frail: 0.66 points-per-month, 95% CI: -1.1, 2.5). In conclusion, frailty is associated with mitigated improvement in global cognition post-KT. Frail recipients may benefit from interventions to improve post-KT cognitive function.

Source: Innovation in Aging

DOI: 10.1093/geroni/igx004.3229