Cystatin C, cognition, and brain MRI findings in 90+-year-olds

Wei Ling Lau; Mark Fisher; Dana Greenia; David Floriolli; Evan Fletcher; Baljeet Singh; Seyed Ahmad Sajjadi; Maria M Corrada; Christina Whittle; Claudia Kawas; Annlia Paganini-Hill

doi:10.1016/j.neurobiolaging.2020.04.022

Cystatin C, cognition, and brain MRI findings in 90+-year-olds

Neurobiol Aging. 2020 Sep:93:78-84. doi: 10.1016/j.neurobiolaging.2020.04.022. Epub 2020 Apr 29.

Authors

Affiliations

¹ Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA, USA. Electronic address: wllau@uci.edu.
² Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Department of Anatomy & Neurobiology, University of California Irvine School of Medicine, Irvine, CA, USA.
³ Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
⁴ Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, CA, USA.
⁵ Imaging of Dementia and Agng Laboratory, Department of Neurology, Center for Neuroscience, University of California, Davis, CA, USA.
⁶ Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
⁷ Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Epidemiology, University of California Irvine School of Medicine, Irvine, CA, USA.
⁸ Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurobiology & Behavior, University of California Irvine School of Medicine, Irvine, CA, USA.
⁹ Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA.

PMID: 32473464
PMCID: PMC7307913
DOI: 10.1016/j.neurobiolaging.2020.04.022

Abstract

Chronic kidney disease is emerging as a novel risk factor for cerebrovascular disease, but this association remains largely unexplored in older adults. Cystatin C is a more accurate measure than creatinine of kidney function in the elderly. We evaluated cystatin C, cognitive function, and brain imaging in 193 participants from The 90+ Study neuroimaging component. The mean age was 93.9 years; 61% were women. Mean cystatin C was 1.62 mg/L with estimated glomerular filtration rate 39.2 mL/min/1.73 m². Performance on measures of global cognition, executive function, and visual-spatial ability declined at higher tertiles of cystatin C (lower kidney function). Higher cystatin C was significantly associated with infratentorial microbleeds and lower gray matter volume. Adjusted risk of incident dementia was increased in the middle and high cystatin C tertile groups compared with the low group (hazard ratio in highest tertile 3.81 [95% confidence interval 1.14-12.7]), which appeared to be explained in part by the presence of cerebral microbleeds. Overall, cystatin C was associated with cognitive performance, brain imaging pathology, and decline to dementia in this oldest-old cohort.

Keywords: Aging; Brain MRI; Chronic kidney disease; Cognition.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Age Factors
Aged, 80 and over
Aging / pathology*
Aging / psychology*
Biomarkers / blood
Brain / diagnostic imaging*
Brain / pathology*
Brain / physiopathology
Cognition*
Cystatin C / blood*
Dementia / diagnosis*
Dementia / psychology
Female
Humans
Magnetic Resonance Imaging*
Male
Renal Insufficiency, Chronic / diagnosis

Substances

Biomarkers
Cystatin C

Abstract

Publication types

MeSH terms

Substances

Grants and funding