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of cystatin C in persons with chronic kidney disease (\n CKD<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Prospective observational study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Chronic Renal Insufficiency Cohort Cognitive Study.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Individuals with a baseline cognitive assessment completed at the same visit as serum cystatin C measurement (N\u00a0=\u00a0821; mean age 64.9, 50.6% male, 48.6% white).<\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n Levels of serum cystatin C were categorized into tertiles; cognitive function was assessed using six neuropsychological tests. Scores on these tests were compared across tertiles of cystatin C using linear regression and logistic regression to examine the association between cystatin C level and cognitive performance (1 standard deviation difference from the mean).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After multivariable adjustment for age, race, education, and medical comorbidities in linear models, higher levels of cystatin C were associated with worse cognition on the modified Mini\u2010Mental State Examination, Buschke Delayed Recall, Trail\u2010Making Test Part (Trails) A and Part B, and Boston Naming (\n P<\/jats:italic>\n \u00a0<\u00a0.05 for all). This association remained statistically significant for Buschke Delayed Recall (\n P<\/jats:italic>\n \u00a0=\u00a0.01) and Trails A (\n P<\/jats:italic>\n \u00a0=\u00a0.03) after additional adjustment for estimated glomerular filtration rate (e\n GFR<\/jats:styled-content>\n ). The highest tertile of cystatin C was associated with greater likelihood of poor performance on Trails A (odds ratio (\n OR<\/jats:styled-content>\n )\u00a0=\u00a02.17, 95% confidence interval (\n CI<\/jats:styled-content>\n )\u00a0=\u00a01.16\u20134.06), Trails B (\n OR\u00a0<\/jats:styled-content>\n =\u00a01.89, 95%\n CI<\/jats:styled-content>\n \u00a0=\u00a01.09\u20133.27), and Boston Naming (\n OR\u00a0<\/jats:styled-content>\n =\u00a01.85, 95%\n CI<\/jats:styled-content>\n \u00a0=\u00a01.07\u20133.19) than the lowest tertile after multivariate adjustment in logistic models.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n In individuals with CKD, higher serum cystatin C levels were associated with worse cognition and greater likelihood of poor cognitive performance on attention, executive function, and naming. Cystatin C is a marker of cognitive impairment and may be associated with cognition independent of e\n GFR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.12986","type":"journal-article","created":{"date-parts":[[2014,8,14]],"date-time":"2014-08-14T10:06:56Z","timestamp":1408010816000},"page":"1623-1629","source":"Crossref","is-referenced-by-count":39,"title":["Higher Levels of Cystatin C Are Associated with Worse Cognitive Function in Older Adults with Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort Cognitive Study"],"prefix":"10.1111","volume":"62","author":[{"given":"Kristine","family":"Yaffe","sequence":"first","affiliation":[{"name":"Department of Psychiatry School of Medicine University of California at San Francisco San Francisco California"},{"name":"Department of Neurology School of Medicine University of California at San Francisco San Francisco California"},{"name":"Department of Epidemiology and Biostatistics School of Medicine 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