Nonlinear Relationship of Non-High-Density Lipoprotein Cholesterol and Cognitive Function in American Elders: A Cross-Sectional NHANES Study (2011–2014)

Abstract

Background: Serum non-high-density lipoprotein-cholesterol (non-HDL-C) levels may be associated with cognitive function. Objective: The objective of this study was to evaluate the association between non-HDL-C and cognitive function among American elders. Methods: We used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). A total of 3,001 participants aged over 60 years were enrolled in our analysis. The cognitive function was evaluated with the word learning subtest from the Consortium to Establish a Registry for Alzheimer’s disease (CERAD W-L), the Animal Fluency Test (AFT), and the digit symbol substitution test (DSST). We also created a composite cognitive z-score to represent a global cognition. We applied multivariate linear regression analyses to estimate the associations between non-HDL-C levels and all domains of cognitive function. Further, the generalized additive model and the smooth curve were conducted to investigate the dose-response relationship between non-HDL-C and global cognition. Results: Serum non-HDL-C was positively associated with global cognition (β= 0.20, 95% CI: 0.11, 0.28), AFT score (β= 0.54, 95% CI: 0.33, 0.76), and DSST score (β= 1.13, 95% CI: 0.56, 1.69) after fully adjusted. While non-HDL-C was not related to CERAD W-L score. In addition, an inverted U-shape curve was observed in the dose-response relationship between non-HDL-C and global cognition (p for non-linearity < 0.001). Conclusion: Serum non-HDL-C is positively and nonlinearly associated with cognitive function among American older adults. Maintaining serum cholesterol levels at an appropriate range may be helpful to the cognitive health of the elderly.

Associations between dietary and blood inflammatory indices and their effects on cognitive function in elderly Americans

“…The Z-score was calculated as Z = (x-m)/σ, where x is the raw score, m is the overall mean, and σ is the overall SD. A Z-score of<-1 is taken to indicate that the person has cognitive impairment ( Wirth et al, 2017 ; Frith et al, 2018 ; Zhang et al, 2022 ).…”

Periodontitis and low cognitive performance: A population‐based study

“…A global cognition score was calculated as the sum of the standardized z‐scores of the CERAD‐WL, AFT, and DSST tests, as previously reported (Li et al, 2019; Q. Zhang et al, 2022). Further details on cognitive function testing methods are reported elsewhere (National Health and Nutrition Examination Survey, 2011–2012, 2013–2014).…”

“…The delayed word recall test (CERAD‐DR), which was scored between 0 and 10, was performed once the two other cognitive exercises (Animal Fluency and DSST) were completed (approximately 8–10 minutes from the start of the word learning trials). The scores obtained in the CERAD‐IR and the CERAD‐DR were then totalled to calculate an overall CERAD‐WL score (Q. Zhang et al, 2022).…”

“…A global cognition score was calculated as the sum of the standardized z-scores of the CERAD-WL, AFT, and DSST tests, as previously reported (Li et al, 2019;Q. Zhang et al, 2022).…”

“…The scores obtained in the CERAD-IR and the CERAD-DR were then totalled to calculate an overall CERAD-WL score (Q. Zhang et al, 2022).…”