Impaired memory function is a frequent yet understudied symptom in kidney transplant recipients. Here, we demonstrate a remote, minimally burdensome memory screener, the Seattle-Groningen Memory Assessment (SGMA), which estimates a patient's speed of forgetting from paired-associate learning. We show that the memory score derived from an 8-minute session is a reliable and accurate measure of an individual's ability for long-term retention. Kidney transplant recipients (n=556) showed more forgetting than (potential) donors (n=408). Memory scores were sensitive to demographics (age and education level), and related to self-reported sleep quality, fatigue, and health-related quality of life. On the physiological level, we were able to link more forgetting in recipients to more monocytes, neutrophils, reticulocytes, and a higher white blood cell count, as well as lower ferritin and more iron deficiency. Overall, this work highlights the potential of computational memory assessment as a minimally burdensome and reliable tool for detecting cognitive impairments in complex multimorbidity populations. The approach may be particularly valuable in research settings where detecting subtle changes in cognitive health, often missed by existing assessments, is crucial for understanding disease progression and treatment effects.

MemoryLab Health BV is a commercial partner directly involved in this project and has a vested interest in the successful validation and implementation of the memory test. This commercial interest is explicitly declared and transparently managed in alignment with the societal aims of the research.

The TransplantLines Biobank and Cohort study was supported by grants from Astellas BV (project code: TransplantLines Biobank and Cohort study); Chiesi Pharmaceuticals BV (project code: PA-SP/PRJ-2020-9136); and NWO/TTW via a partnership program with DSM, Animal Nutrition and Health, The Netherlands (project code: 14939). The project was co-financed by the Dutch Ministry of Economic Affairs and Climate Policy by means of so-called PPP-allowances, made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships (project code: PPP-2019-032 , PPP-2022-015). The funders had no role in the study design, data collection, analysis, reporting, or the decision to submit for publication.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The TransplantLines study protocol was approved by the Medical Ethics Review Committee (METc) of the University Medical Center Groningen (UMCG), University of Groningen, The Netherlands (METc 2014/077), adheres to the UMCG Biobank Regulation, and is in accordance with the WMA Declaration of Helsinki and the Declaration of Istanbul.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

SGMA data and analysis scripts are publicly available. Due to patient confidentiality, the clinical data associated with the SGMA dataset are not publicly available but can be made available upon request. Access to this clinical dataset requires a minimal access procedure consisting of a request by email (datarequest.transplantlinesumcg.nl). A response will be provided within 2 weeks. This access procedure is to ensure that the clinical data are being requested for research/scientific purposes only and thus complies with the informed consent signed by TransplantLines participants, which specifies that the collected data will not be used by commercial parties.

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