KIDNEY transplantation was associated with substantial improvements in physical frailty and mild cognitive impairment (MCI) over 2 years, while better earlier cognitive function predicted lower subsequent frailty.
The prospective multicentre longitudinal study included 230 adult kidney transplant recipients who were followed for up to 2 years after transplantation. The study was nested within the Swiss Transplant Cohort Study and examined the trajectories and interrelationship between physical frailty and MCI following transplantation.
Physical frailty was assessed using the adapted Fried Frailty Phenotype, while cognitive function was evaluated using the Montreal Cognitive Assessment. The researchers assessed changes in both measures over time and examined whether frailty and cognitive function predicted subsequent changes in each other.
Physical frailty declined from 8.3% before transplantation to below 2% during follow-up. Pre-frailty also decreased, falling from 54.3% before transplantation to 27.6% at 2 years.
MCI prevalence decreased from 42.6% before transplantation to 31.3% at 2 years. Longitudinal analyses indicated that physical frailty was more dynamic than cognitive function during follow-up.
The analysis also identified an association between earlier cognitive function and later physical frailty. Better cognitive function at earlier assessment points predicted lower subsequent frailty. In contrast, physical frailty did not significantly predict later cognitive function.
The findings suggested that cognitive assessment could have a role in identifying patients at risk of persistent physical frailty following kidney transplantation. This may be particularly relevant given the differing trajectories observed for physical and cognitive function.
The researchers supported routine assessment of both physical frailty and cognitive function before and after kidney transplantation. Integrating these assessments could help improve risk stratification and inform more individualised patient care.
The study highlighted the potential importance of considering physical and cognitive function together when monitoring recovery after transplantation. Further clinical attention to these measures could support identification of patients who remain at greater risk of persistent frailty during the post-transplant period.
Reference
Beerli N et al. Evolution and interrelation of physical frailty and mild cognitive impairment up to two years after kidney transplantation: a multi-center prospective cohort study. Transpl Int. 2026;39:16175.
Featured image: megaflopp on Adobe Stock
Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
