Prevalence of frailty and cognitive impairment in older 1 transplant candidates. A 2 preview to the Kidney Transplantation in Older People (KTOP): impact of frailty on 3 outcomes study.

Journal article


Thind, A, Rule, A, Goodall, D, Levy, S, Brice, S, Dor, F, Evans, N, Ospalla, D, Thomas, N., Wellsted, D, Johanssen, L, Willicombe, M and Brown, E (2022). Prevalence of frailty and cognitive impairment in older 1 transplant candidates. A 2 preview to the Kidney Transplantation in Older People (KTOP): impact of frailty on 3 outcomes study. BMC Nephrology.
AuthorsThind, A, Rule, A, Goodall, D, Levy, S, Brice, S, Dor, F, Evans, N, Ospalla, D, Thomas, N., Wellsted, D, Johanssen, L, Willicombe, M and Brown, E
Abstract

Background
Kidney transplantation in older people has increased, however older transplant recipients experience mixed outcomes that invariably impacts on their quality of life. The increased
vulnerability of older end stage kidney disease patients to frailty and cognitive impairment, may partially explain the differences in outcomes observed.

The Kidney Transplantation in Older People (KTOP): impact of frailty on clinical outcomes 64 study is an active clinical study aiming to explore the experience of older people waiting for and undergoing transplantation. In this manuscript we present the study protocol, the study
cohort, and the prevalence of frailty and cognitive impairment identified at recruitment.

Methods
The KTOP study is a single centre, prospective, mixed methods, observational study. Recruitment began in October 2019. All patients aged 60 or above either active on the
deceased donor waitlist or undergoing live donor transplantation were eligible for recruitment.
Recruited participants completed a series of questionnaires assessing frailty, cognition, and quality of life, which are repeated at defined time points whilst on the waitlist and post transplant. Clinical data was concurrently collected. Any participants identified as frail or vulnerable were also eligible for enrolment into the qualitative sub-study.

Results
208 participants have been recruited (age 60-78). Baseline Montreal Cognitive Assessments 77 were available for 173 participants, with 63 (36.4%) participants identified as having scores below normal (score <26). Edmonton Frail Scale assessments were available for 184 participants, with 29 participants (15.8%) identified as frail (score ³8), and a further 37 participants (20.1%) identified as being vulnerable (score 6-7).

Conclusion
In the KTOP study cohort we have identified a prevalence of 36.4% of participants with MoCA cores suggestive of cognitive impairment, and a prevalence of frailty of 15.8% at recruitment. A further 20.1% were vulnerable. As formal testing for cognition and frailty is not routinely
incorporated into the work up of older people across many units, the presence and significance of these conditions is likely not known. Ultimately the KTOP study will report on how these parameters evolve over time and following a transplant, and describe their impact on quality
of life and clinical outcomes.

Keywordskidney transplantation; older people; frailty; cognition
Year2022
JournalBMC Nephrology
PublisherBMC
ISSN1471-2369
Publication process dates
Accepted22 Jul 2022
Deposited28 Jul 2022
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