High Low-Density Lipoprotein Cholesterol Inversely Relates to Dementia in Community-Dwelling Older Adults: The Shanghai Aging Study

Zhou, Fang; Deng, Wei; Ding, Ding; Zhao, Qianhua; Liang, Xiaoniu; Wang, Fei; Luo, Jianfeng; Lv, Zheng; Guo, Qihao; Zhao, Hong

doi:10.3389/fneur.2018.00952

Cited by 29 publications

(32 citation statements)

References 41 publications

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“…Several studies reported that TC and LDL-C are related to cognitive impairment in China old adults [12,13]. In our study, no associations were found between TC, TG and LDL-C and cognitive impairment in China centenarians.…”

Section: Discussioncontrasting

confidence: 82%

“…et al reported that HDL-C was negatively associated with cognitive impairment in elderly general population [10,11]. Ma, C. et al found that TC and LDL-C were risk factors for cognitive functions and HDL-C was not [12,13]. Anstey, K. J. et al claimed that late-life measured TC and HDL-C were not associated with risk of mild cognitive impairment, AD, or any dementia [14].…”

Section: Introductionmentioning

confidence: 99%

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Associations of Serum Lipids with Risk of Cognitive Impairment in Chinese Centenarians

Chen¹,

Huang²,

Ning³

et al. 2021

Preprint

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Background Dyslipidaemia and cognitive impairment are common in old adults and risks of both of them increase with increasing age. However, the relationship between lipids and cognitive impairment in longevous people is still unclear. This study aimed to assess the association between serum lipids and cognitive impairment in Chinese centenarians. Methods In a cross-sectional study, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were biochemically measured in 924 centenarians and cognitive functions were evaluated. Multiple logistic regression analysis was used to examine the associations of lipids with cognitive impairment and the risks for cognitive impairment associated with quartile of serum lipid concentrations. Results The results demonstrated HDL-C was an independent beneficial factor for cognitive impairment after controlling for the potential covariates (Odds ratio, OR = 0.350, 95% Confidence interval, CI = 0.159–0.774; P = 0.009). An inverse association of HDL-C with cognitive impairment was found (P for trend = 0.001) and the association remained significant after adjusting for possible cofounders (P for trend = 0.012). The OR of cognitive impairment for the lowest versus highest quartiles of HDL-C was 1.96 (95%CI, 1.09–3.45). Conclusions The results indicated that low HDL-C is likely to be harmful for cognitive functions in centenarians. The cognitive function of longevous persons with low HDL-C concentrations deserves more attention.

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Section: Discussioncontrasting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Associations of Serum Lipids with Risk of Cognitive Impairment in Chinese Centenarians

Chen¹,

Huang²,

Ning³

et al. 2021

Preprint

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“…It has been recognized that higher TC and LDL-C was cognitively detrimental due to correlated CVD risk among middle-aged and elderly individuals. However, a recent cross-sectional study has reported higher level of LDL-C may be considered as a potential protective factor against cognition decline [40]. Such evidence needs future replication but may have important clinical implications when taking that lower TC and LDL-C may be correspondingly detrimental owing to poor nutritional status and harmful effects on brain among the elderly.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal and nonlinear relations of dietary and Serum cholesterol in midlife with cognitive decline: results from EMCOA study

Zhang

Wang

et al. 2019

Mol Neurodegeneration

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Background: Previous studies regarding the cholesterol-cognition relationship in midlife have generated conflicting results. We thus investigated whether dietary and blood cholesterol were associated with cognitive decline. Methods: Participants were drawn from a large cohort study entitled the Effects and Mechanism Investigation of Cholesterol and Oxysterol on Alzheimer's disease (EMCOA) study. We included 2514 participants who completed a selection of comprehensive cognitive tests and were followed for an average of 2.3 years. Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were assessed and dietary intakes were investigated by food frequency questionnaire (FFQ) at baseline. Apolipoprotein E (APOE) was genotyped by Kompetitive Allele Specific PCR (KASP) sequencing. Non-highdensity lipoprotein cholesterol (Non-HDL-C) and LDL-C/HDL-C ratio were calculated. The longitudinal effects of dietary and blood cholesterol on risk of global cognitive decline (decrease in Montreal Cognitive Assessment (MoCA) > 2 points) were examined using Cox proportional hazards models. The nonlinear associations with global and domain-specific cognitive decline was evaluated with mixed effect linear models.Results: In Cox proportional hazards models, neither cholesterol nor egg intake was associated with a higher risk of accelerated global cognitive decline. In contrast, the higher serum concentrations of TC, LDL-C, non-HDL-C and LDL-C/HDL-C ratio were positively associated with accelerated global cognitive decline regardless of being evaluated continuously or categorically while higher HDL-C was positively associated with accelerated global cognitive decline only when being evaluated categorically (all P < 0.05). In mixed effect linear models, quadratic and longitudinal relations of dietary cholesterol and egg intakes to global cognition, processing speed and executive function were observed. Moreover, there were inverted U-shaped relations of HDL-C, with processing speed and executive function but U-shaped relations of HDL-C and LDL-C/HDL-C ratio with verbal memory. Adverse linear associations of higher LDL-C and LDL-C/HDL-C ratio with multiple cognitive comes were also revealed. Additionally adjusting for APOE genotype did not modify cholesterol-cognition associations. Dietary and serum cholesterol had variable associations with global and domain-specific cognitive decline across educational groups.Conclusion: Differential associations between dietary/serum cholesterol and cognitive decline across different domains of function were observed in a particular population of middle-aged and elderly Chinese. Interventions to improve cognitive reserve regarding dietary instruction and lipid management should be tailored according to specific target.(Continued on next page)

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“…However, the association between cholesterol and cognitive function has been divergent in recent years. A study using urban community participants from Shanghai, China indicated that higher LDL-C was associated with low risk of dementia [6]. There were also randomized trials indicated that the therapy of lowering cholesterol by statins diminished cognitive function slightly [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Cholesterol is associated with cognitive impairment closely owing to its disturbance on cardiovascular and other cognition related risk factors [1]. Epidemiological cross-sectional and prospective studies have found higher total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C) was associated with worse cognitive function [2][3][4], while other similar studies put forward a reverse conclusion [5,6]. The use of high-dose statins was associated with better visuospatial memory and executive ability, but some randomized placebo-controlled trials of lipid-lowering treatment found non-signi cant between-group differences of cognitive function [7,8].…”

Section: Introductionmentioning

confidence: 99%

Gender-specific association between unidirectional variation of cholesterol and cognitive decline: a longitudinal study of middle-aged and elderly adults

Liu

Zhou

Zheng

et al. 2021

Preprint

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Background Higher fluctuation of cholesterol has been shown associated with cognitive decline. But the association between unidirectional variation of cholesterol and cognition remains unclear. In the present study, we examined the association between variation of cholesterol from normal to high level or from high to normal level and cognition. Methods A total of 4,915 participants (mean age, 57.7 years; 49.2% female) with normal cognition in baseline (2011) from the China Health and Retirement Longitudinal Study (CHARLS) were included. Plasma total cholesterol (TC), non-high-density lipoprotein cholesterol (NHDL-C), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were divided into two clusters according to cutoff in 2011 and 2015, respectively. Participants were divided into four groups: normal-normal, normal-high, high-normal and high-high. Cognitive functions were assessed by episodic memory and mental intactness. The binary logistic regression was used to analyze the association of cholesterol variation with cognitive decline. Results Participants with increased cholesterol were more likely had lower incidence of cognitive decline. The fluctuations of cholesterol were more likely occurred in females. The odds ratio (OR) and 95% confidence interval (CI) of global cognitive decline in normal-high compared with normal-normal group of TC was 0.61 (0.36–1.03), and significant only in females [OR and 95% CI: 0.50 (0.26–0.97)]; the risk of memory function decline in high-normal group compared with high-high group was increased both in males [OR and 95% CI: 1.98 (1.02–4.05)] and females [OR and 95% CI: 1.61 (1.01–2.74)]. The similarly results were shown in NHDL-C groups [OR and 95% CI of global cognitive decline in normal-high group: 0.50 (0.26–0.95) for overall; 0.38 (0.17–0.85) for females]; but the risk of memory function decline in high-normal group only increased in females [OR and 95% CI: 1.64 (1.02–2.25)]. The risk of mental intactness decline in males significantly decreased in high-normal group of LDL-C compared with high-high group [OR and 95% CI: 0.30 (0.13–0.67)] and increased in high-high compared with normal-normal group [OR and 95% CI: 2.27 (1.18–2.98)]. Conclusions Longitudinal decreasing of TC or NHDL-C is detrimental to cognitive function, especially in females. But LDL-C is still a risk factor of cognitive decline in males.

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High Low-Density Lipoprotein Cholesterol Inversely Relates to Dementia in Community-Dwelling Older Adults: The Shanghai Aging Study

Cited by 29 publications

References 41 publications

Associations of Serum Lipids with Risk of Cognitive Impairment in Chinese Centenarians

Associations of Serum Lipids with Risk of Cognitive Impairment in Chinese Centenarians

Longitudinal and nonlinear relations of dietary and Serum cholesterol in midlife with cognitive decline: results from EMCOA study

Gender-specific association between unidirectional variation of cholesterol and cognitive decline: a longitudinal study of middle-aged and elderly adults

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