Cognitive assessment in a predominantly Hispanic and Native American population in New Mexico and its association with kidney transplant wait‐listing

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Abstract

Abstract The association between cognitive function and the likelihood of kidney transplant (KT) wait‐listing, especially in minority populations, has not been clearly delineated. We performed a retrospective review of our pre‐KT patients, who consist mainly of Hispanics and Native Americans, over a 16‐month period. We collected data on baseline demographics and the Montreal Cognitive Assessment (MoCA) score, at the initial KT evaluation. We defined cognitive impairment as MoCA scores of <24. We constructed linear regression models to identify associations between baseline characteristics with MoCA scores and used Cox proportional hazards models to assess associations between MoCA score and KT wait‐listing. During the study period, 154 patients completed the MoCA during their initial evaluation. Mean (standard deviation) MoCA scores were 23.9 (4.6), with 58 (38%) participants scoring <24. Advanced age, lower education and being on dialysis were associated with lower MoCA scores. For every one‐point increase in MoCA, the likelihood of being wait‐listed increased 1.10‐fold (95% CI 1.01‐1.19, P = .022). Being Native American and having kidney disease due to diabetes or hypertension were associated with longer time to wait‐listing. Cognitive impairment was common in our pre‐KT patients and was associated with a lower likelihood of KT wait‐listing.

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