AUTHOR=Beerli Nadine , Wehrle Manuel , Binet Isabelle , Dickenmann Michael , Golshayan Déla , Hadaya Karine , Huynh-Do Uyen , Kressig Reto W. , De Geest Sabina , Mauthner Oliver 
  
TITLE=Evolution and interrelation of physical frailty and mild cognitive impairment up to two years after kidney transplantation: a multi-center prospective cohort study
  
JOURNAL=Transplant International
  
VOLUME=Volume 39 - 2026
  
YEAR=2026
  
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2026.16175
  
DOI=10.3389/ti.2026.16175
  
ISSN=1432-2277
  
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.