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

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

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

Wei Ling Lau et al. Neurobiol Aging. 2020 Sep.

. 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.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest / Disclosures: None.

Figures

**Figure 1.**
Cohort construction from The 90+ Study participants. Of the total 1921 participants, 496 were seen between 2014 (when the neuroimaging component of the study began) and 2018. Between 2014–2018, 258 participants gave informed consent to participate in the neuroimaging study. Cystatin C level was determined for 193 and brain MRI was completed in 129 participants.

**Figure 2.**
Distributions of cystatin C and stages of chronic kidney disease (CKD, determined by estimated glomerular filtration rate or eGFR) in 193 individuals aged 90+ years.

**Figure 3.**
Increased risk of incident dementia was associated with higher cystatin C tertile groups in 171 individuals aged 90+ years (non-demented at baseline). Hazard ratios and 95% confidence intervals are adjusted for sex, education (not college graduate, college graduate), smoking (never, past), and medical histories (no, yes) of hypertension, diabetes, coronary artery disease, heart attack, heart valve disease, congestive heart failure, stroke, TIA, vascular disease, and depression.

See this image and copyright information in PMC

References

1. Aljabar P, Heckemann RA, Hammers A, Hajnal JV, Rueckert D, 2009. Multi-atlas based segmentation of brain images: atlas selection and its effect on accuracy. Neuroimage 46(3), 726–738. - PubMed
1. APA, 1994. Diagnostic and Statistical Manual of Mental Disorders, 4th. ed. American Psychiatric Association, Washington, DC.
1. Bennett IJ, Greenia DE, Maillard P, Sajjadi SA, DeCarli C, Corrada MM, Kawas CH, 2017. Age-related white matter integrity differences in oldest-old without dementia. Neurobiol Aging 56, 108–114. - PMC - PubMed
1. Chelluboina B, Vemuganti R, 2019. Chronic kidney disease in the pathogenesis of acute ischemic stroke. J Cereb Blood Flow Metab 39(10), 1893–1905. - PMC - PubMed
1. Corrada MM, Brookmeyer R, Berlau D, Paganini-Hill A, Kawas CH, 2008. Prevalence of dementia after age 90: results from the 90+ study. Neurology 71(5), 337–343. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical