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Updating the Evidence on the Association between Serum Cholesterol and Risk of Late-Life Dementia: Review and Meta-Analysis.

Abstract

BACKGROUND

Cohort studies have reported that midlife high total serum cholesterol (TC) is associated with increased risk of Alzheimer's disease (AD) in late-life but findings have been based on few studies and previous reviews have been limited by a lack of compatible data.

OBJECTIVE

We synthesized all high quality data from cohort studies reporting on the association between total serum cholesterol measured and late-life cognitive outcomes including Alzheimer's disease (AD), vascular dementia (VaD), any dementia, mild cognitive impairment (MCI), and cognitive decline.

METHODS

The literature was searched up to October 2016 using a registered protocol. Thirty-four articles meeting study criteria were identified. Seventeen studies published from 1996 to 2014, including 23,338 participants were included in meta-analyses.

RESULTS

Relative risk of developing AD for adults with high TC in midlife was 2.14 (95% CI 1.33-3.44) compared with normal cholesterol. Individual studies that could not be pooled also reported high TC in midlife increased the risk of MCI and cognitive decline in late-life. High TC in late-life was not associated with MCI, AD, VaD, any dementia, or cognitive decline. Late-life measured HDL cholesterol and triglycerides were not associated with increased risk of VaD, and HDL was not associated with risk of MCI, AD, or any dementia. There were insufficient data to examine other cholesterol sub-fractions, sex differences, or APOE interactions.

CONCLUSIONS

Significant gaps in the literature regarding TC and late-life dementia remain. Evidence suggests that high midlife TC increases risk of late-life AD, and may correlate with the onset of AD pathology.

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  • Authors+Show Affiliations

    ,

    Dementia Collaborative Research Centre - Early Diagnosis and Prevention, Research School of Population Health, The Australian National University, Australia. Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia.

    ,

    Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia.

    Dementia Collaborative Research Centre - Early Diagnosis and Prevention, Research School of Population Health, The Australian National University, Australia. Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia.

    Source

    MeSH

    Alzheimer Disease
    Cholesterol
    Cognitive Dysfunction
    Cohort Studies
    Dementia
    Humans
    Risk Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    27911314

    Citation

    Anstey, Kaarin J., et al. "Updating the Evidence On the Association Between Serum Cholesterol and Risk of Late-Life Dementia: Review And Meta-Analysis." Journal of Alzheimer's Disease : JAD, vol. 56, no. 1, 2017, pp. 215-228.
    Anstey KJ, Ashby-Mitchell K, Peters R. Updating the Evidence on the Association between Serum Cholesterol and Risk of Late-Life Dementia: Review and Meta-Analysis. J Alzheimers Dis. 2017;56(1):215-228.
    Anstey, K. J., Ashby-Mitchell, K., & Peters, R. (2017). Updating the Evidence on the Association between Serum Cholesterol and Risk of Late-Life Dementia: Review and Meta-Analysis. Journal of Alzheimer's Disease : JAD, 56(1), pp. 215-228. doi:10.3233/JAD-160826.
    Anstey KJ, Ashby-Mitchell K, Peters R. Updating the Evidence On the Association Between Serum Cholesterol and Risk of Late-Life Dementia: Review And Meta-Analysis. J Alzheimers Dis. 2017;56(1):215-228. PubMed PMID: 27911314.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Updating the Evidence on the Association between Serum Cholesterol and Risk of Late-Life Dementia: Review and Meta-Analysis. AU - Anstey,Kaarin J, AU - Ashby-Mitchell,Kimberly, AU - Peters,Ruth, PY - 2016/12/3/pubmed PY - 2018/2/22/medline PY - 2016/12/3/entrez KW - Cholesterol KW - cognitive decline KW - dementia KW - lipids KW - review KW - risk factors SP - 215 EP - 228 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 56 IS - 1 N2 - BACKGROUND: Cohort studies have reported that midlife high total serum cholesterol (TC) is associated with increased risk of Alzheimer's disease (AD) in late-life but findings have been based on few studies and previous reviews have been limited by a lack of compatible data. OBJECTIVE: We synthesized all high quality data from cohort studies reporting on the association between total serum cholesterol measured and late-life cognitive outcomes including Alzheimer's disease (AD), vascular dementia (VaD), any dementia, mild cognitive impairment (MCI), and cognitive decline. METHODS: The literature was searched up to October 2016 using a registered protocol. Thirty-four articles meeting study criteria were identified. Seventeen studies published from 1996 to 2014, including 23,338 participants were included in meta-analyses. RESULTS: Relative risk of developing AD for adults with high TC in midlife was 2.14 (95% CI 1.33-3.44) compared with normal cholesterol. Individual studies that could not be pooled also reported high TC in midlife increased the risk of MCI and cognitive decline in late-life. High TC in late-life was not associated with MCI, AD, VaD, any dementia, or cognitive decline. Late-life measured HDL cholesterol and triglycerides were not associated with increased risk of VaD, and HDL was not associated with risk of MCI, AD, or any dementia. There were insufficient data to examine other cholesterol sub-fractions, sex differences, or APOE interactions. CONCLUSIONS: Significant gaps in the literature regarding TC and late-life dementia remain. Evidence suggests that high midlife TC increases risk of late-life AD, and may correlate with the onset of AD pathology. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/27911314/Updating_the_Evidence_on_the_Association_between_Serum_Cholesterol_and_Risk_of Late_Life_Dementia:_Review_and Meta_Analysis_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-160826 DB - PRIME DP - Unbound Medicine ER -