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Serum cholesterol changes after midlife and late-life cognition: twenty-one-year follow-up study.

Abstract

BACKGROUND

Longitudinal studies have shown that high serum total cholesterol (TC) at midlife is a risk factor for dementia/Alzheimer disease. The significance of TC later in life is unclear.

OBJECTIVE

To investigate changes in serum TC from midlife to late life and their relationship with late-life cognition.

METHODS

Participants of the Cardiovascular Risk Factors, Aging and Dementia study were derived from random, population-based samples previously studied in a survey in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1,449 individuals aged 65 to 79 were reexamined in 1998.

RESULTS

Serum TC levels decreased in most individuals. High midlife TC represented a risk factor for more severe cognitive impairment later in life, and the values were significantly different between the control, mild cognitive impairment, and dementia groups. There were no significant differences in serum TC at reexamination. A moderate decrease in serum TC from midlife to late life (0.5 to 2 mmol/L) was significantly associated with the risk of a more impaired late-life cognitive status, even after adjusting for age, follow-up time, sex, years of formal education, midlife cholesterol, changes in body mass index, APOE epsilon4 genotype, history of myocardial infarction/stroke/diabetes, and lipid-lowering treatment.

CONCLUSIONS

The relationship between serum total cholesterol (TC) and dementia seems to be bidirectional. High midlife serum TC is a risk factor for subsequent dementia/Alzheimer disease, but decreasing serum TC after midlife may reflect ongoing disease processes and may represent a risk marker for late-life cognitive impairment.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Neuroscience and Neurology, University of Kuopio, Finland.

    , , , , , ,

    Source

    Neurology 68:10 2007 Mar 06 pg 751-6

    MeSH

    Aged
    Apolipoproteins E
    Cholesterol
    Cognition Disorders
    Dementia
    Female
    Humans
    Longitudinal Studies
    Male
    Risk Factors

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17339582

    Citation

    Solomon, A, et al. "Serum Cholesterol Changes After Midlife and Late-life Cognition: Twenty-one-year Follow-up Study." Neurology, vol. 68, no. 10, 2007, pp. 751-6.
    Solomon A, Kåreholt I, Ngandu T, et al. Serum cholesterol changes after midlife and late-life cognition: twenty-one-year follow-up study. Neurology. 2007;68(10):751-6.
    Solomon, A., Kåreholt, I., Ngandu, T., Winblad, B., Nissinen, A., Tuomilehto, J., ... Kivipelto, M. (2007). Serum cholesterol changes after midlife and late-life cognition: twenty-one-year follow-up study. Neurology, 68(10), pp. 751-6.
    Solomon A, et al. Serum Cholesterol Changes After Midlife and Late-life Cognition: Twenty-one-year Follow-up Study. Neurology. 2007 Mar 6;68(10):751-6. PubMed PMID: 17339582.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Serum cholesterol changes after midlife and late-life cognition: twenty-one-year follow-up study. AU - Solomon,A, AU - Kåreholt,I, AU - Ngandu,T, AU - Winblad,B, AU - Nissinen,A, AU - Tuomilehto,J, AU - Soininen,H, AU - Kivipelto,M, PY - 2007/3/7/pubmed PY - 2007/3/23/medline PY - 2007/3/7/entrez SP - 751 EP - 6 JF - Neurology JO - Neurology VL - 68 IS - 10 N2 - BACKGROUND: Longitudinal studies have shown that high serum total cholesterol (TC) at midlife is a risk factor for dementia/Alzheimer disease. The significance of TC later in life is unclear. OBJECTIVE: To investigate changes in serum TC from midlife to late life and their relationship with late-life cognition. METHODS: Participants of the Cardiovascular Risk Factors, Aging and Dementia study were derived from random, population-based samples previously studied in a survey in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1,449 individuals aged 65 to 79 were reexamined in 1998. RESULTS: Serum TC levels decreased in most individuals. High midlife TC represented a risk factor for more severe cognitive impairment later in life, and the values were significantly different between the control, mild cognitive impairment, and dementia groups. There were no significant differences in serum TC at reexamination. A moderate decrease in serum TC from midlife to late life (0.5 to 2 mmol/L) was significantly associated with the risk of a more impaired late-life cognitive status, even after adjusting for age, follow-up time, sex, years of formal education, midlife cholesterol, changes in body mass index, APOE epsilon4 genotype, history of myocardial infarction/stroke/diabetes, and lipid-lowering treatment. CONCLUSIONS: The relationship between serum total cholesterol (TC) and dementia seems to be bidirectional. High midlife serum TC is a risk factor for subsequent dementia/Alzheimer disease, but decreasing serum TC after midlife may reflect ongoing disease processes and may represent a risk marker for late-life cognitive impairment. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17339582/Serum_cholesterol_changes_after_midlife_and_late_life_cognition:_twenty_one_year_follow_up_study_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=17339582 DB - PRIME DP - Unbound Medicine ER -