Younger kidney transplant (KT) candidates and recipients may have cognitive impairment due chronic diseases and reliance on dialysis. To quantify cognitive impairment burden by age across the KT care continuum, we leveraged a two-center cohort study of 3,854 KT candidates at evaluation, 1,114 recipients at admission, and 405 recipients at 1-year post-KT with measured global cognitive performance (3MS) or executive function (Trail Making Test). We also estimated burden of severe cognitive impairment that affects functional dependence (ADL<6 or IADL<8). Among KT candidates, global cognitive impairment (18-34years:11.1%; 35-49years:14.0%; 50-64years:19.5%; ≥65years:22.0%) and severe cognitive impairment burden (18-34years:1.1%; 35-49years:3.0%; 50-64years:6.2%; ≥65years:7.7%) increased linearly with age. Among KT recipients at admission, global cognitive impairment (18-34years:9.1%; 35-49years:6.1%; 50-64years:9.3%; ≥65years:15.7%) and severe cognitive impairment burden (18-34years:1.4%; 35-49years:1.4%; 50-64years:2.2%; ≥65years:4.6%) was lower. Despite lowest burden of cognitive impairment among KT recipients at 1-year post-KT across all ages (18-34years:1.7%; 35-49years:3.4%; 50-64years:4.3%; ≥65years:6.5%), many still exhibited severe cognitive impairment (18-34years:0.0%; 35-49years:1.9%; 50-64years:2.4%; ≥65years:3.5%). Findings were consistent for executive function impairment. While cognitive impairment increases with age, younger KT candidates have a high burden comparable to community-dwelling older adults, with some potentially suffering from severe forms. Transplant centers should consider routinely screening patients during clinical care encounters regardless of age. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.