Prevalence and Correlates of Cognitive Impairment in Kidney Transplant Patients Using the DemTect—Results of a KTx360 Substudy

Abstract

Cognitive impairment in kidney transplantation (KTx) patients is associated with allograft survival and mortality. However, the prevalence of cognitive impairment after KTx is still understudied. Thus, we aimed to assess the prevalence of cognitive impairment in KTx patients and to identify sociodemographic, medical, donation-specific, and psychological variables associated with cognitive impairment. In this cross-sectional two-center study, 583 KTx patients participated in a structured post-transplant care program. The DemTect was used to assess cognition, and cognitive impairment was defined as a score of < 13. Mean age was 52.11 years, 59% were male, 27.4% had ≥12 years of school attendance, and 85.9% had hypertension. The prevalence of cognitive impairment was 15.6%. Cognitive impairment was significantly associated with higher age, male sex, lower educational level, subjective perception of cognitive decline, higher rates of hypertension, lower kidney functioning, and obesity (BMI > 30 kg/m2). Using logistic regression analysis, all variables except age remained significant. Our results suggest that cognitive impairment affects a significant number of patients after KTx. Transplant centers may consider screening for cognitive impairment using objective tests, especially in patients with a high-risk profile. Furthermore, studies with longitudinal designs are required in order to assess moderators and mediators for cognitive trajectories.

Cognitive disorders in patients with chronic kidney disease: specificities of clinical assessment

“…However, it is still not fully clear which screening tool should be used. Recent studies observed discrepancies in the prevalence of CI in KT patients, probably because the tests were different (MoCA, DemTect tool) [ 62 ].…”

A cross‐sectional study exploring cognitive impairment in kidney failure

“…Most of the understanding of cognitive impairment from these studies was in the CKD G5D group who were treated by haemodialysis, and since then several studies have provided detailed comparisons of cognition between CKD groups and general populations (e.g., the systematic review by O'Lone et al, 2016) or improvements in cognition post kidney transplantation (Joshee et al, 2018). Recently, Nöhre et al (2019) reported a prevalence of 15.6% cognitive impairment in those with a kidney transplant, and in another systematic review, Shea et al (2019) reported a pooled prevalence rate of 28.7% of cognitive impairment for those receiving PD. Only Lambert et al (2017) has explored the prevalence of cognitive impairment across four groups of patients with CKD G4 and G5 finding that 16.7% in CKD G4 and G5, 48% of undertaking PD, 55.6% undertaking HD were cognitively impaired.…”

<p>Knowledge About Immunosuppressant Medication and Its Correlates in a German Kidney Transplant Population – Results of a KTx360° Substudy</p>

“…From a clinical perspective, it seems to be of utmost importance to identify these patients and to provide them with sufficient support. 34 Regarding transplant-specific outcomes, we found no statistically significant associations. Other studies reported a correlation between knowledge and a living kidney donation.…”