Problem: Kidney transplant recipients (KTRs) are at higher risk of dementia than the general population. Geriatricians should be aware of issues facing older KTRs as dementia is associated with poorer outcomes.
Aims: This case series describes the diagnoses that KTRs receive after Cognitive, Dementia and Memory Service (CDAMS) clinic. It will describe the cognitive assessment and the relationship to time of kidney transplant.
Methods: Data was collected from the medical record for individuals that attended both Kidney Transplant (KT) clinic and CDAMs clinic between 2012 and 2024. The relevant data on demographics, cognitive symptoms, KT, comorbidities and mortality were tabulated.
Results: Twenty-five patients attended both clinics. The mean onset of cognitive symptoms occurred eight years after transplantation and three people had symptoms preceding KT. Prevalence of Alzheimer’s Dementia, Vascular Dementia, Mixed Dementia, and Frontotemporal Dementia were 3/25, 3/25, 2/25 and 1/25 respectively. The mode was Mild Cognitive Impairment (8/25, MCI), including 3 with Vascular Cognitive Impairment. Three had Delirium and three had Mood Disorder. Depressive symptoms were prevalent in 20/25. One died from meningoencephalitis after being diagnosed with MCI. Seven died and four resided in residential aged care.
Conclusions: This study found a high prevalence of depressive symptoms and highlights that some people have cognitive symptoms prior to KT. Currently, our analysis is limited by a lack of data on KTRs without cognitive impairment and is vulnerable to selection bias. Advocacy for geriatric assessment of KTRs before and after transplantation is important.