Cystatin C, Cognition and Brain MRI Findings in 90+ Year-olds,Neurobiology of Aging

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Cystatin C, Cognition and Brain MRI Findings in 90+ Year-olds
Neurobiology of Aging ( IF 3.7 ) Pub Date : 2020-09-01 , DOI: 10.1016/j.neurobiolaging.2020.04.022
Wei Ling Lau ₁ , Mark Fisher ₂ , Dana Greenia ₃ , David Floriolli ₄ , Evan Fletcher ₅ , Baljeet Singh ₅ , Seyed Ahmad Sajjadi ₆ , Maria M Corrada ₇ , Christina Whittle ₃ , Claudia Kawas ₈ , Annlia Paganini-Hill ₉

Affiliation

Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA, USA.
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.
Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, CA, USA.
Imaging of Dementia and Agng Laboratory, Department of Neurology, Center for Neuroscience, University of California, Davis, CA, USA.
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 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.
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.
Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA.

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.

中文翻译：

90 岁以上老人的胱抑素 C、认知和脑部 MRI 结果

慢性肾病正在成为脑血管疾病的新危险因素，但这种关联在老年人中仍未得到充分探索。胱抑素 C 是比肌酐更准确地衡量老年人肾功能的指标。我们评估了来自 The 90+ Study 神经影像学组件的 193 名参与者的胱抑素 C、认知功能和大脑成像。平均年龄为 93.9 岁；61% 是女性。平均胱抑素 C 为 1.62 mg/L，估计肾小球滤过率为 39.2 mL/min/1.73 m2。在胱抑素 C 较高的三分位数（较低的肾功能）下，整体认知、执行功能和视觉空间能力的测量表现下降。较高的胱抑素 C 与幕下微出血和较低的灰质体积显着相关。与低组相比，中等和高胱抑素 C 三分位数组的调整后痴呆发生风险增加（最高三分位数的风险比为 3.81 [95% 置信区间 1.14-12.7]），这似乎部分是由于存在脑微出血。总体而言，在这个年龄最大的队列中，胱抑素 C 与认知表现、脑成像病理学和痴呆症下降有关。

更新日期：2020-09-01

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