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Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Research Article

Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study

Author(s): Yujie Guo, Pengfei Li, Xiaojun Ma, Xiaochen Huang, Zhuoheng Liu, Xiuwen Ren, Yuhui Yang, Nicholas V. Halm-Lutterodt and Linhong Yuan*

Volume 17, Issue 6, 2020

Page: [556 - 565] Pages: 10

DOI: 10.2174/1567205017666200810165758

Price: $65

Abstract

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults.

Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI).

Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects.

Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.

Keywords: Cholesterol, cognition, the elderly, geriatrics, mild cognitive impairment, cardiovascular diseases.

[1]
Jia J, Zhou A, Wei C, et al. The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese. Alzheimers Dement 2014; 10(4): 439-47.
[http://dx.doi.org/10.1016/j.jalz.2013.09.008] [PMID: 24418053]
[2]
Song F, Poljak A, Smythe GA, Sachdev P. Plasma biomarkers for mild cognitive impairment and Alzheimer’s disease. Brain Res Brain Res Rev 2009; 61(2): 69-80.
[http://dx.doi.org/10.1016/j.brainresrev.2009.05.003] [PMID: 19464319]
[3]
Power MC, Rawlings A, Sharrett AR, et al. Association of midlife lipids with 20-year cognitive change: A cohort study. Alzheimers Dement 2018; 14(2): 167-77.
[http://dx.doi.org/10.1016/j.jalz.2017.07.757] [PMID: 28916238]
[4]
Reynolds CA, Gatz M, Prince JA, Berg S, Pedersen NL. Serum lipid levels and cognitive change in late life. J Am Geriatr Soc 2010; 58(3): 501-9.
[http://dx.doi.org/10.1111/j.1532-5415.2010.02739.x] [PMID: 20398119]
[5]
Evans RM, Emsley CL, Gao S, et al. Serum cholesterol, APOE genotype, and the risk of Alzheimer’s disease: A population-based study of African Americans. Neurology 2000; 54(1): 240-2.
[http://dx.doi.org/10.1212/WNL.54.1.240] [PMID: 10636159]
[6]
Yaffe K, Barrett-Connor E, Lin F, Grady D. Serum lipoprotein levels, statin use, and cognitive function in older women. Arch Neurol 2002; 59(3): 378-84.
[http://dx.doi.org/10.1001/archneur.59.3.378] [PMID: 11890840]
[7]
Kalmijn S, Foley D, White L, et al. Metabolic cardiovascular syndrome and risk of dementia in Japanese-American elderly men. The Honolulu-Asia aging study. Arterioscler Thromb Vasc Biol 2000; 20(10): 2255-60.
[http://dx.doi.org/10.1161/01.ATV.20.10.2255] [PMID: 11031212]
[8]
Wood WG, Igbavboa U, Eckert GP, Johnson-Anuna LN, Müller WE. Is hypercholesterolemia a risk factor for Alzheimer’s disease? Mol Neurobiol 2005; 31(1-3): 185-92.
[http://dx.doi.org/10.1385/MN:31:1-3:185] [PMID: 15953820]
[9]
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): 215-28.
[http://dx.doi.org/10.3233/JAD-160826] [PMID: 27911314]
[10]
Cai C, Xiao R, Van Halm-Lutterodt N, et al. Association of MTHFR, SLC19A1 genetic polymorphism, serum folate, vitamin B12 and Hcy status with cognitive functions in chinese adults. Nutrients 2016; 8(10) E665
[http://dx.doi.org/10.3390/nu8100665] [PMID: 27783031]
[11]
Dong L, Xiao R, Cai C, et al. Diet, lifestyle and cognitive function in old Chinese adults. Arch Gerontol Geriatr 2016; 63: 36-42.
[http://dx.doi.org/10.1016/j.archger.2015.12.003] [PMID: 26791169]
[12]
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53(4): 695-9.
[http://dx.doi.org/10.1111/j.1532-5415.2005.53221.x] [PMID: 15817019]
[13]
Luis CA, Keegan AP, Mullan M. Cross validation of the Montreal Cognitive Assessment in community dwelling older adults residing in the Southeastern US. Int J Geriatr Psychiatry 2009; 24(2): 197-201.
[http://dx.doi.org/10.1002/gps.2101] [PMID: 18850670]
[14]
Lu J, Li D, Li F, et al. Montreal cognitive assessment in detecting cognitive impairment in Chinese elderly individuals: A population-based study. J Geriatr Psychiatry Neurol 2011; 24(4): 184-90.
[http://dx.doi.org/10.1177/0891988711422528] [PMID: 22228824]
[15]
Fratiglioni L, Viitanen M, von Strauss E, Tontodonati V, Herlitz A, Winblad B. Very old women at highest risk of dementia and Alzheimer’s disease: Incidence data from the Kungsholmen Project, Stockholm. Neurology 1997; 48(1): 132-8.
[http://dx.doi.org/10.1212/WNL.48.1.132] [PMID: 9008508]
[16]
Hixson JE, Vernier DT. Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. J Lipid Res 1990; 31(3): 545-8.
[PMID: 2341813]
[17]
Mahwah NJ. Serum cholesterol, the brain, and cognitive functioning. Neuropsychol Cardiovasc Dis 2001; pp. 37-59.
[18]
van Vliet P. Cholesterol and late-life cognitive decline. J Alzheimers Dis 2012; 30(2): S147-62.
[http://dx.doi.org/10.3233/JAD-2011-111028] [PMID: 22269162]
[19]
Purnell C, Gao S, Callahan CM, Hendrie HC. Cardiovascular risk factors and incident Alzheimer disease: A systematic review of the literature. Alzheimer Dis Assoc Disord 2009; 23(1): 1-10.
[http://dx.doi.org/10.1097/WAD.0b013e318187541c] [PMID: 18703981]
[20]
Elias PK, Elias MF, D’Agostino RB, Sullivan LM, Wolf PA. Serum cholesterol and cognitive performance in the Framingham Heart Study. Psychosom Med 2005; 67(1): 24-30.
[http://dx.doi.org/10.1097/01.psy.0000151745.67285.c2] [PMID: 15673620]
[21]
Panza F, D’Introno A, Colacicco AM, et al. Lipid metabolism in cognitive decline and dementia. Brain Res Brain Res Rev 2006; 51(2): 275-92.
[http://dx.doi.org/10.1016/j.brainresrev.2005.11.007] [PMID: 16410024]
[22]
Schreurs BG. The effects of cholesterol on learning and memory. Neurosci Biobehav Rev 2010; 34(8): 1366-79.
[http://dx.doi.org/10.1016/j.neubiorev.2010.04.010] [PMID: 20470821]
[23]
Reitz C, Luchsinger J, Tang MX, Manly J, Mayeux R. Impact of plasma lipids and time on memory performance in healthy elderly without dementia. Neurology 2005; 64(8): 1378-83.
[http://dx.doi.org/10.1212/01.WNL.0000158274.31318.3C] [PMID: 15851727]
[24]
Helzner EP, Luchsinger JA, Scarmeas N, et al. Contribution of vascular risk factors to the progression in Alzheimer disease. Arch Neurol 2009; 66(3): 343-8.
[http://dx.doi.org/10.1001/archneur.66.3.343] [PMID: 19273753]
[25]
Rantanen K, Strandberg AY, Salomaa V, et al. Cardiovascular risk factors and glucose tolerance in midlife and risk of cognitive disorders in old age up to a 49-year follow-up of the Helsinki businessmen study. Ann Med 2017; 49(6): 462-9.
[http://dx.doi.org/10.1080/07853890.2017.1290821] [PMID: 28151011]
[26]
Zou Y, Zhu Q, Deng Y, et al. Vascular risk factors and mild cognitive impairment in the elderly population in Southwest China. Am J Alzheimers Dis Other Demen 2014; 29(3): 242-7.
[http://dx.doi.org/10.1177/1533317513517042] [PMID: 24375574]
[27]
Olié E, Picot MC, Guillaume S, Abbar M, Courtet P. Measurement of total serum cholesterol in the evaluation of suicidal risk. J Affect Disord 2011; 133(1-2): 234-8.
[http://dx.doi.org/10.1016/j.jad.2011.03.028] [PMID: 21521628]
[28]
Li G, Shofer JB, Kukull WA, et al. Serum cholesterol and risk of Alzheimer disease: A community-based cohort study. Neurology 2005; 65(7): 1045-50.
[http://dx.doi.org/10.1212/01.wnl.0000178989.87072.11] [PMID: 16217057]
[29]
Tan ZS, Seshadri S, Beiser A, et al. Plasma total cholesterol level as a risk factor for Alzheimer disease: The Framingham Study. Arch Intern Med 2003; 163(9): 1053-7.
[http://dx.doi.org/10.1001/archinte.163.9.1053] [PMID: 12742802]
[30]
Lv YB, Yin ZX, Chei CL, et al. Serum cholesterol levels within the high normal range are associated with better cognitive performance among chinese elderly. J Nutr Health Aging 2016; 20(3): 280-7.
[http://dx.doi.org/10.1007/s12603-016-0701-6] [PMID: 26892577]
[31]
Cheng Y, Jin Y, Unverzagt FW, et al. The relationship between cholesterol and cognitive function is homocysteine-dependent. Clin Interv Aging 2014; 9: 1823-9.
[PMID: 25364240]
[32]
Hamson DK, Roes MM, Galea LA. Sex hormones and cognition: Neuroendocrine influences on memory and learning. Compr Physiol 2016; 6(3): 1295-337.
[http://dx.doi.org/10.1002/cphy.c150031] [PMID: 27347894]
[33]
Rosario ER, Chang L, Head EH, Stanczyk FZ, Pike CJ. Brain levels of sex steroid hormones in men and women during normal aging and in Alzheimer’s disease. Neurobiol Aging 2011; 32(4): 604-13.
[http://dx.doi.org/10.1016/j.neurobiolaging.2009.04.008] [PMID: 19428144]
[34]
Carroll JC, Rosario ER, Kreimer S, et al. Sex differences in β-amyloid accumulation in 3xTg-AD mice: Role of neonatal sex steroid hormone exposure. Brain Res 2010; 1366: 233-45.
[http://dx.doi.org/10.1016/j.brainres.2010.10.009] [PMID: 20934413]
[35]
Javitt NB. Alzheimer’s disease: Neuroprogesterone, epoxycholesterol, and ABC transporters as determinants of neurodesmosterol tissue levels and its role in amyloid protein processing. J Alzheimers Dis 2013; 35(3): 441-50.
[http://dx.doi.org/10.3233/JAD-130044] [PMID: 23455994]
[36]
van Exel E, de Craen AJ, Gussekloo J, et al. Association between high-density lipoprotein and cognitive impairment in the oldest old. Ann Neurol 2002; 51(6): 716-21.
[http://dx.doi.org/10.1002/ana.10220] [PMID: 12112077]
[37]
Warren MW, Hynan LS, Weiner MF. Lipids and adipokines as risk factors for Alzheimer’s disease. J Alzheimers Dis 2012; 29(1): 151-7.
[http://dx.doi.org/10.3233/JAD-2012-111385] [PMID: 22232009]
[38]
Zhou Z, Liang Y, Zhang X, et al. Low-density lipoprotein cholesterol and alzheimer’s disease: A systematic review and meta-analysis. Front Aging Neurosci 2020; 12: 5.
[http://dx.doi.org/10.3389/fnagi.2020.00005] [PMID: 32082137]
[39]
Kivipelto M, Helkala EL, Hänninen T, et al. Midlife vascular risk factors and late-life mild cognitive impairment: A population-based study. Neurology 2001; 56(12): 1683-9.
[http://dx.doi.org/10.1212/WNL.56.12.1683] [PMID: 11425934]
[40]
Packard CJ, Westendorp RG, Stott DJ, et al. Prospective study of pravastatin in the elderly at risk group. Association between apolipoprotein E4 and cognitive decline in elderly adults. J Am Geriatr Soc 2007; 55(11): 1777-85.
[http://dx.doi.org/10.1111/j.1532-5415.2007.01415.x] [PMID: 17979899]
[41]
van Exel E, Gussekloo J, Houx P, et al. Atherosclerosis and cognitive impairment are linked in the elderly. The Leiden 85-plus Study. Atherosclerosis 2002; 165(2): 353-9.
[http://dx.doi.org/10.1016/S0021-9150(02)00253-8] [PMID: 12417287]
[42]
West R, Beeri MS, Schmeidler J, et al. Better memory functioning associated with higher total and low-density lipoprotein cholesterol levels in very elderly subjects without the apolipoprotein e4 allele. Am J Geriatr Psychiatry 2008; 16(9): 781-5.
[http://dx.doi.org/10.1097/JGP.0b013e3181812790] [PMID: 18757771]
[43]
Katsumata Y, Todoriki H, Higashiuesato Y, et al. Very old adults with better memory function have higher low-density lipoprotein cholesterol levels and lower triglyceride to high-density lipoprotein cholesterol ratios: KOCOA Project. J Alzheimers Dis 2013; 34(1): 273-9.
[http://dx.doi.org/10.3233/JAD-121138] [PMID: 23207484]
[44]
Moroney JT, Tang MX, Berglund L, et al. Low-density lipoprotein cholesterol and the risk of dementia with stroke. JAMA 1999; 282(3): 254-60.
[http://dx.doi.org/10.1001/jama.282.3.254] [PMID: 10422994]
[45]
Sterling NW, Lichtenstein M, Lee E-Y, et al. Higher plasma LDL-cholesterol is associated with preserved executive and fine motor functions in Parkinson’s disease. Aging Dis 2016; 7(3): 237-45.
[http://dx.doi.org/10.14336/AD.2015.1030] [PMID: 27330838]
[46]
Beydoun MA, Beason-Held LL, Kitner-Triolo MH, et al. Statins and serum cholesterol’s associations with incident dementia and mild cognitive impairment. J Epidemiol Community Health 2011; 65(11): 949-57.
[http://dx.doi.org/10.1136/jech.2009.100826] [PMID: 20841372]
[47]
Pfrieger FW. Cholesterol homeostasis and function in neurons of the central nervous system. Cell Mol Life Sci 2003; 60(6): 1158-71.
[http://dx.doi.org/10.1007/s00018-003-3018-7] [PMID: 12861382]
[48]
Hu P, Seeman TE, Harris TB, Reuben DB. Does inflammation or undernutrition explain the low cholesterol-mortality association in high-functioning older persons? MacArthur studies of successful aging. J Am Geriatr Soc 2003; 51(1): 80-4.
[http://dx.doi.org/10.1034/j.1601-5215.2002.51014.x] [PMID: 12534850]
[49]
La Rue A, Koehler KM, Wayne SJ, Chiulli SJ, Haaland KY, Garry PJ. Nutritional status and cognitive functioning in a normally aging sample: A 6-y reassessment. Am J Clin Nutr 1997; 65(1): 20-9.
[http://dx.doi.org/10.1093/ajcn/65.1.20] [PMID: 8988908]
[50]
Anstey KJ, Lipnicki DM, Low LF. Cholesterol as a risk factor for dementia and cognitive decline: A systematic review of prospective studies with meta-analysis. Am J Geriatr Psychiatry 2008; 16(5): 343-54.
[http://dx.doi.org/10.1097/01.JGP.0000310778.20870.ae] [PMID: 18448847]
[51]
Svensson T, Sawada N, Mimura M, Nozaki S, Shikimoto R, Tsugane S. The association between midlife serum high-density lipoprotein and mild cognitive impairment and dementia after 19 years of follow-up. Transl Psychiatry 2019; 9(1): 26.
[http://dx.doi.org/10.1038/s41398-018-0336-y] [PMID: 30659169]
[52]
Sabbagh M, Zahiri HR, Ceimo J, et al. Is there a characteristic lipid profile in Alzheimer’s disease? J Alzheimers Dis 2004; 6(6): 585-9.
[http://dx.doi.org/10.3233/JAD-2004-6602] [PMID: 15665398]
[53]
Corley J, Starr JM, Deary IJ. Serum cholesterol and cognitive functions: The Lothian Birth Cohort 1936. Int Psychogeriatr 2015; 27(3): 439-53.
[http://dx.doi.org/10.1017/S1041610214001197] [PMID: 25023928]
[54]
Lu Y, An Y, Yu H, et al. Sex-specific nonlinear associations between serum lipids and different domains of cognitive function in middle to older age individuals. Metab Brain Dis 2017; 32(4): 1089-97.
[http://dx.doi.org/10.1007/s11011-017-9999-y] [PMID: 28374237]
[55]
Voight BF, Peloso GM, Orho-Melander M, et al. Plasma HDL cholesterol and risk of myocardial infarction: A mendelian randomisation study. Lancet 2012; 380(9841): 572-80.
[http://dx.doi.org/10.1016/S0140-6736(12)60312-2] [PMID: 22607825]
[56]
Braekkan SK, Borch KH, Mathiesen EB, Njølstad I, Hansen JB. HDL-cholesterol and future risk of venous thromboembolism: The Tromsø Study. J Thromb Haemost 2009; 7(8): 1428-30.
[http://dx.doi.org/10.1111/j.1538-7836.2009.03481.x] [PMID: 19453941]
[57]
Manninen V, Tenkanen L, Koskinen P, et al. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Implications for treatment. Circulation 1992; 85(1): 37-45.
[http://dx.doi.org/10.1161/01.CIR.85.1.37] [PMID: 1728471]
[58]
Xia W, Zhang B, Yang Y, Wang P, Yang Y, Wang S. Poorly controlled cholesterol is associated with cognitive impairment in T2DM: A resting-state fMRI study. Lipids Health Dis 2015; 14: 47.
[http://dx.doi.org/10.1186/s12944-015-0046-x] [PMID: 25989796]
[59]
Yang J, Chen T, Li W, Liu L, Teo K, Yusuf S. Current status of medication usage for cardiovascular disease and hypertension in china (PURE-China Study). Circulation 2012; 126A: 15144.
[60]
Chen Y, Li L, Zhang Q, et al. China Kadoorie Biobank Study. Use of drug treatment for secondary prevention of cardiovascular disease in urban and rural communities of China: China Kadoorie Biobank Study of 0.5 million people. Int J Cardiol 2014; 172(1): 88-95.
[http://dx.doi.org/10.1016/j.ijcard.2013.12.065] [PMID: 24461961]

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