Hypercholesterolemia in elders is associated with slower cognitive decline: A prospective, population-based study (NEDICES)

Benito‐León, Julián; Vega-Quiroga, Saturio; Villarejo-Galende, Alberto; Bermejo‐Pareja, Félix

doi:10.1016/j.jns.2015.02.016

Cited by 29 publications

(24 citation statements)

References 36 publications

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“…Although participants with hearing and vision loss were always diagnosed as CI by mistake when taking scale tests, we still found that difficulties in hearing and seeing led to cognitive decline because they failed to have enough cognitive resource capacity for tasks or they were isolated from society [ 32 , 33 ]. Importantly, other studies have indicated that hypertension, hyperuricemia, and hypercholesterolemia may be associated with cognitive functions [ 34 – 36 ], but this was not found in the present study, perhaps due to the differences in methodology, intervention, course of diseases, and comorbidities. Methods currently used to prevent cognitive decline in elderly people with chronic diseases are pharmacological interventions, physical exercises, and cognitive training using mental exercises [ 37 ].…”

Section: Discussioncontrasting

confidence: 84%

A Risk Factor Analysis of Cognitive Impairment in Elderly Patients with Chronic Diseases in a Chinese Population

Fang

Zhao

et al. 2017

Med Sci Monit

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BackgroundThis study analyzed the risk factors of cognitive impairment (CI) in elderly patients with chronic diseases.Material/MethodsIn total of 385 elderly patients with chronic diseases were selected and assigned into CI and normal groups. The activities of daily living (ADL), global deterioration scale (GDS), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), patient-generated subjective global assessment (PG-SGA), and mini nutritional assessment (MNA) were performed to analyze the differences between the 2 groups. Logistic regression analysis was conducted for risk factors of CI in elderly patients with chronic diseases.ResultsThere were differences in age, education level, type 2 diabetes mellitus, multifocal cerebral infarction, hearing, and eyesight between CI and normal groups. Patients in the CI group showed more CD4+ cells, more admission times, and higher GDS scores than the normal group. Also, MMSE and MoCA scores revealed differences in total score, directive force, attention and calculating ability, language, delayed memory, reading comprehension, writing, and visual-spatial ability between the 2 groups. The number of B and CD8+ cells, ADL, and MNA scores were protective factors, while cerebral infarction history, number of CD4+ cells, admission times, GDS score, and age were risk factors of CI in elderly patients with chronic diseases.ConclusionsOur study provides evidence that cerebral infarction history, number of CD4+ cells, admission times, GDS score, and age are risk factors of CI in elderly patients with chronic diseases.

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Section: Discussioncontrasting

confidence: 84%

A Risk Factor Analysis of Cognitive Impairment in Elderly Patients with Chronic Diseases in a Chinese Population

Fang

Zhao

et al. 2017

Med Sci Monit

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“…In the Longitudinal Aging Study Amsterdam, higher total cholesterol at baseline (mean age: 76 years) was associated with slower decline on the Mini-Mental State Examination (MMSE), processing speed, and memory performance tasks over 6 years. [12] Similarly, in both the Neurological Disorders in Central Spain (NEDICES) cohort[15] and a small sample of non-demented persons,[16] hypercholesterolemia in late life was associated with slower decline on the MMSE over 3 years. To the contrary, hypertriglyceridemia and low HDL-c at baseline (mean age: 73 years) were significantly associated with greater decline on the MMSE but not other cognitive tasks over a 2 to 4 year follow-up in the Three-City study.…”

Section: Discussionmentioning

confidence: 99%

Association of midlife lipids with 20‐year cognitive change: A cohort study

Power

Rawlings

Sharrett

et al. 2017

Alzheimer's & Dementia

110

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“…In dementia, this is often observed when the same factors that increase dementia risk when present in midlife become associated with reduced risk for dementia onset or progression when examined within a few years prior to dementia onset . Thus, hypercholesterolaemia, high body mass index (BMI) and hypertension are risk factors for dementia in midlife but act as protective factors for dementia onset and rate of cognitive decline when examined within a few years prior to dementia onset . The nature of the reverse epidemiology phenomenon is not completely established, but it appears that issues of competing risks are at play .…”

Section: Difficulties Faced When Examining the Association Between Stmentioning

confidence: 99%

Connecting the brain cholesterol and renin–angiotensin systems: potential role of statins and RAS‐modifying medications in dementia

et al. 2018

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Petek B, Sweden; S€ odersjukhuset, Stockholm, Sweden). Connecting the brain cholesterol and reninangiotensin systems: potential role of statins and RAS-modifying medications in dementia (Review). J Intern Med 2018;284: 620-642.Millions of people worldwide receive agents targeting the renin-angiotensin system (RAS) to treat hypertension or statins to lower cholesterol. The RAS and cholesterol metabolic pathways in the brain are autonomous from their systemic counterparts and are interrelated through the cholesterol metabolite 27-hydroxycholesterol (27-OHC). These systems contribute to memory and dementia pathogenesis through interference in the amyloid-beta cascade, vascular mechanisms, glucose metabolism, apoptosis, neuroinflammation and oxidative stress. Previous studies examining the relationship between these treatments and cognition and dementia risk have produced inconsistent results. Defining the blood-brain barrier penetration of these medications has been challenging, and the mechanisms of action on cognition are not clearly established. Potential biases are apparent in epidemiological and clinical studies, such as reverse epidemiology, indication bias, problems defining medication exposure, uncertain and changing doses, and inappropriate grouping of outcomes and medications. This review summarizes current knowledge of the brain cholesterol and RAS metabolism and the mechanisms by which these pathways affect neurodegeneration. The putative mechanisms of action of statins and medications inhibiting the RAS will be examined, together with prior clinical and animal studies on their effects on cognition. We review prior epidemiological studies, analysing their strengths and biases, and identify areas for future research. Understanding the pathophysiology of the brain cholesterol system and RAS and their links to neurodegeneration has enormous potential. In future, well-designed epidemiological studies could identify potential treatments for Alzheimer's disease (AD) amongst medications that are already in use for other indications.2 Promotion of oxidative stress by acting on LRX in astroglia [90,91].Brain cholesterol and RAS in dementia / B. Petek et al.

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Hypercholesterolemia in elders is associated with slower cognitive decline: A prospective, population-based study (NEDICES)

Cited by 29 publications

References 36 publications

A Risk Factor Analysis of Cognitive Impairment in Elderly Patients with Chronic Diseases in a Chinese Population

A Risk Factor Analysis of Cognitive Impairment in Elderly Patients with Chronic Diseases in a Chinese Population

Association of midlife lipids with 20‐year cognitive change: A cohort study

Connecting the brain cholesterol and renin–angiotensin systems: potential role of statins and RAS‐modifying medications in dementia

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