Long-term cognitive impairments in kidney transplant recipients: impact on participation and quality of life

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Abstract

BACKGROUND: Cognitive impairment is often present shortly after transplantation in kidney transplant recipients (KTR). To date, it is unknown whether these impairments persist on the long term, to what extent they are associated with disease related variables and whether they affect societal participation and quality of life (QoL) of KTR.

METHOD: This study was part of the TransplantLines Biobank & Cohort study in the University Medical Center Groningen. 131 KTR, with a mean age of 53.6 years (SD = 13.5) transplanted ≥ 1 year ago (M = 11.2 years, range 1-41.7 years), were included, and compared to 306 healthy controls (HC). KTR and HC were well-matched; there were no significant differences regarding age, sex and education. All participants were assessed with neuropsychological tests measuring memory, mental speed, attention and executive functioning, and with questionnaires examining societal participation and QoL.

RESULTS: Compared to HC, KTR performed significantly worse on memory, mental speed and measures of executive functioning (all p-values < 0.05). Moreover, 16% of KTR met the criteria for mild cognitive impairment (MCI), compared to 2.6% of the HC. MCI in KTR was not significantly correlated with age and disease related variables. Poorer cognitive functioning was significantly related to lower levels of societal participation and to lower QoL (all p-values < 0.01).

CONCLUSIONS: This study shows long-term cognitive impairments in KTR which are not related with disease related variables. Neuropsychological assessment is important to timely signal these impairments, given their serious negative impact on societal participation and QoL.

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