Middle-Aged Cholesterol & Golden-Years Dementia

Even moderately elevated cholesterol levels in midlife are strongly associated with later risk of Alzheimer's disease (AD) and vascular dementia (VaD), new research suggests [1].

Lead author Dr Alina Solomon (University of Kuopio, Finland) and colleagues used data from the Kaiser Permanente Northern California Medical Group to investigate the relationship between midlife cholesterol and dementia and found that cholesterol defined as "borderline high" of 200 to 239 mg/dL increase risk.

"Both physicians and patients need to know that elevated cholesterol increases the risk not only for heart disease, but also for dementia," Solomon said. "The most important finding was that even moderately elevated cholesterol at midlife can increase the risk of both AD and VaD later in life."

The study is published in the August 2008 issue of Dementia and Geriatric Cognitive Disorders.
The study included 9844 subjects who had undergone detailed health evaluations during 1964 to1973, when they were ages 40 to 45 years.

Comparing those with cholesterol below 200mg,dL, the analysis showed Alzheimer's disease hazard ratio for midlife borderline cholesterol (200-239 mg/dL) and 1.57 for high cholesterol (>240 mg/dL).

The risk of vascularr dementia hazard ratios were 1.50 for borderline cholesterol and 1.26 for high cholesterol.

Dr Robert Stewart (King's College London, UK) said that the Solomon study data are "convincing." "In general there is now a large body of evidence that indicates that what is bad for the heart is bad for the brain—that is, that the well-known risk factors for coronary heart disease and stroke are also risk factors for dementia (whether this is classified as Alzheimer's disease or vascular dementia)," Stewart said. [2]

"So the real message for clinicians is not to do anything differently, but to be aware that what they should be doing already—identifying and treating high cholesterol, high blood pressure, and diabetes and promoting healthy diet and active lifestyles—is likely to have more benefits than originally envisaged and should reduce risk of dementia as well as reducing risk of cardiovascular disease."

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[1] Solomon A, Kivipelto M, Wolozin B, et al. Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later. Dement Geriatr Cogn Disord 2009; 28:75-80
[2] Kelly, Janis Elevated cholesterol in midlife increases dementia risk. The Heart.Org August 11, 2009.