Evolution and interrelation of physical frailty and mild cognitive impairment up to two years after kidney transplantation: a multi-center prospective cohort study.

Authors

Nadine Beerli, Manuel Wehrle, Isabelle Binet, Michael Dickenmann, Déla Golshayan, Karine Hadaya, Uyen Huynh-Do, Reto W Kressig, Sabina De Geest, Oliver Mauthner

Published in

Transplant international : official journal of the European Society for Organ Transplantation. Volume 39. Pages 16175. Epub Sep 21, 2026.

Abstract

Kidney transplantation (KT) is the preferred treatment for kidney failure, providing superior survival and quality of life compared with haemodialysis. However, the demand for transplantation exceeds organ availability, underscoring the need to optimize pre- and post-transplant care. Physical frailty and mild cognitive impairment (MCI) are important predictors of post-transplant outcomes, yet their long-term trajectories remain insufficiently understood. This prospective multicentre longitudinal study, nested within the Swiss Transplant Cohort Study, included 230 adult KT recipients followed for up to 2 years after transplantation. Physical frailty was assessed using the adapted Fried Frailty Phenotype and MCI using the Montreal Cognitive Assessment. Physical frailty declined from 8.3% before transplantation to below 2% during follow-up, while pre-frailty decreased from 54.3% to 27.6% at 2 years. MCI prevalence declined from 42.6% to 31.3%. Longitudinal analyses demonstrated that physical frailty was more dynamic than cognitive function. Better cognitive function at earlier time points predicted lower subsequent frailty, whereas frailty did not significantly predict later cognitive function. These findings suggest that cognitive assessment may help identify patients at risk of persistent frailty and support the routine assessment of both physical frailty and cognitive function before and after KT to improve risk stratification and guide individualized patient care.

PMID:
42835482
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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