Peters, Ruth

Xu, Ying

Antikainen, Riitta

Beckett, Nigel

Gussekloo, Jacobijn

Jagger, Carol

Jukema, Johan Wouter

Keinanen-Kiukaanniemi, Sirkka

Rydén, Lina

Skoog, Ingmar

Staessen, Jan A

Thijs, Lutgarde

Trompet, Stella

Tully, Phillip J

Tzourio, Christophe

Anstey, Kaarin J

2021-11

<i><b>Introduction:</b></i> Although increased cholesterol level has been acknowledged as a risk factor for dementia, evidence synthesis based on published data has yielded mixed results. This is especially relevant in older adults where individual studies report non-linear relationships between cholesterol and cognition and, in some cases, find higher cholesterol associated with a lower risk of subsequent cognitive decline or dementia. Prior evidence synthesis based on published results has not allowed us to focus on older adults or to standardize analyses across studies. Given our ageing population, an increased risk of dementia in older adults, and the need for proportionate treatment in this age group, an individual participant data (IPD) meta-analysis is timely. <b><i>Method:</i></b> We combined data from 8 studies and over 21,000 participants aged 60 years and over in a 2-stage IPD to examine the relationship between total, high-density, and low-density lipoprotein (HDL and LDL) cholesterol and subsequent incident dementia or cognitive decline, with the latter categorized using a reliable change index method. <b><i>Results:</i></b> Meta-analyses found no relationship between total, HDL, or LDL cholesterol (per millimoles per litre increase) and risk of cognitive decline in this older adult group averaging 76 years of age. For total cholesterol and cognitive decline: odds ratio (OR) 0.93 (95% confidence interval [CI] 0.86: 1.01) and for incident dementia: OR 1.01 [95% CI 0.89: 1.13]. This was not altered by rerunning the analyses separately for statin users and non-users or by the presence of an <i>APOE</i> e4 allele. <b><i>Conclusion:</i></b> There were no clear consistent relationships between cholesterol and cognitive decline or dementia in this older adult group, nor was there evidence of effect modification by statin use. Further work is needed in younger populations to understand the role of cholesterol across the life-course and to identify any relevant intervention points. This is especially important if modification of cholesterol is to be further evaluated for its potential influence on risk of cognitive decline or dementia.

Dementia and Geriatric Cognitive Disorders, 50(4), p. 318-325

1421-9824

1420-8008

34700321

https://hdl.handle.net/1959.11/51766

en

S Karger AG

Evaluation of High Cholesterol and Risk of Dementia and Cognitive Decline in Older Adults Using Individual Patient Meta-Analysis

Journal Article

Publication