Serum cholesterol and risk of Alzheimer disease: A community-based cohort study

Gail Li, J. B. Shofer, W. A. Kukull, E. R. Peskind, D. W. Tsuang, John C.S. Breitner, W. McCormick, J. D. Bowen, L. Teri, G. D. Schellenberg, E. B. Larson

Research output: Contribution to journalArticle

Abstract

Objectives: To examine the association of serum total cholesterol (TC) and high density lipoprotein (HDL) levels and subsequent incidence of dementia and Alzheimer disease (AD) in a population-based cohort study. Methods: A cohort of cognitively intact persons, aged 65 and older, was randomly selected from Group Health Cooperative (GHC), a large health maintenance organization, and was assessed biennially for dementia. Premorbid levels of TC and HDL were obtained from a computerized clinical laboratory database at GHC. Cox proportional hazards regression was used to calculate hazard ratios (HR, 95% CI) for dementia and AD associated with quartiles of TC and HDL levels. Results: Of the 2,356 eligible participants, 2,141 had at least one serum TC measure prior to the initial enrollment. Using the lowest TC quartiles as the reference group, the HR in the highest TC quartiles was not significantly elevated for dementia (1.16, 0.81 to 1.67) or for AD (1.00, 0.61 to 1.62) after adjusting for age, sex, education, baseline cognition, vascular comorbidities, body mass index, and lipid-lowering agent use. Serum HDL showed a similar lack of significant association with risk of dementia or AD. Models that included the presence of one or more APOE-ε4 alleles showed a typical association of ε4 with AD risk. This association was not materially modified by inclusion of TC level. Conclusion: The data do not support an association between serum total cholesterol or high density lipoprotein in late life and subsequent risk of dementia or Alzheimer disease (AD). The increased risk of AD with APOE-ε4 is probably not mediated by serum total cholesterol levels.

Original languageEnglish (US)
Pages (from-to)1045-1050
Number of pages6
JournalNeurology
Volume65
Issue number7
DOIs
StatePublished - Oct 11 2005
Externally publishedYes

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Dementia
Alzheimer Disease
Cohort Studies
Cholesterol
HDL Cholesterol
Serum
Sex Education
Health Maintenance Organizations
Health
HDL Lipoproteins
Cognition
Blood Vessels
Comorbidity
Body Mass Index
Alleles
Databases
Lipids
Incidence
Population

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Li, G., Shofer, J. B., Kukull, W. A., Peskind, E. R., Tsuang, D. W., Breitner, J. C. S., ... Larson, E. B. (2005). Serum cholesterol and risk of Alzheimer disease: A community-based cohort study. Neurology, 65(7), 1045-1050. https://doi.org/10.1212/01.wnl.0000178989.87072.11

Serum cholesterol and risk of Alzheimer disease : A community-based cohort study. / Li, Gail; Shofer, J. B.; Kukull, W. A.; Peskind, E. R.; Tsuang, D. W.; Breitner, John C.S.; McCormick, W.; Bowen, J. D.; Teri, L.; Schellenberg, G. D.; Larson, E. B.

In: Neurology, Vol. 65, No. 7, 11.10.2005, p. 1045-1050.

Research output: Contribution to journalArticle

Li, G, Shofer, JB, Kukull, WA, Peskind, ER, Tsuang, DW, Breitner, JCS, McCormick, W, Bowen, JD, Teri, L, Schellenberg, GD & Larson, EB 2005, 'Serum cholesterol and risk of Alzheimer disease: A community-based cohort study', Neurology, vol. 65, no. 7, pp. 1045-1050. https://doi.org/10.1212/01.wnl.0000178989.87072.11
Li, Gail ; Shofer, J. B. ; Kukull, W. A. ; Peskind, E. R. ; Tsuang, D. W. ; Breitner, John C.S. ; McCormick, W. ; Bowen, J. D. ; Teri, L. ; Schellenberg, G. D. ; Larson, E. B. / Serum cholesterol and risk of Alzheimer disease : A community-based cohort study. In: Neurology. 2005 ; Vol. 65, No. 7. pp. 1045-1050.
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abstract = "Objectives: To examine the association of serum total cholesterol (TC) and high density lipoprotein (HDL) levels and subsequent incidence of dementia and Alzheimer disease (AD) in a population-based cohort study. Methods: A cohort of cognitively intact persons, aged 65 and older, was randomly selected from Group Health Cooperative (GHC), a large health maintenance organization, and was assessed biennially for dementia. Premorbid levels of TC and HDL were obtained from a computerized clinical laboratory database at GHC. Cox proportional hazards regression was used to calculate hazard ratios (HR, 95{\%} CI) for dementia and AD associated with quartiles of TC and HDL levels. Results: Of the 2,356 eligible participants, 2,141 had at least one serum TC measure prior to the initial enrollment. Using the lowest TC quartiles as the reference group, the HR in the highest TC quartiles was not significantly elevated for dementia (1.16, 0.81 to 1.67) or for AD (1.00, 0.61 to 1.62) after adjusting for age, sex, education, baseline cognition, vascular comorbidities, body mass index, and lipid-lowering agent use. Serum HDL showed a similar lack of significant association with risk of dementia or AD. Models that included the presence of one or more APOE-ε4 alleles showed a typical association of ε4 with AD risk. This association was not materially modified by inclusion of TC level. Conclusion: The data do not support an association between serum total cholesterol or high density lipoprotein in late life and subsequent risk of dementia or Alzheimer disease (AD). The increased risk of AD with APOE-ε4 is probably not mediated by serum total cholesterol levels.",
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T2 - A community-based cohort study

AU - Li, Gail

AU - Shofer, J. B.

AU - Kukull, W. A.

AU - Peskind, E. R.

AU - Tsuang, D. W.

AU - Breitner, John C.S.

AU - McCormick, W.

AU - Bowen, J. D.

AU - Teri, L.

AU - Schellenberg, G. D.

AU - Larson, E. B.

PY - 2005/10/11

Y1 - 2005/10/11

N2 - Objectives: To examine the association of serum total cholesterol (TC) and high density lipoprotein (HDL) levels and subsequent incidence of dementia and Alzheimer disease (AD) in a population-based cohort study. Methods: A cohort of cognitively intact persons, aged 65 and older, was randomly selected from Group Health Cooperative (GHC), a large health maintenance organization, and was assessed biennially for dementia. Premorbid levels of TC and HDL were obtained from a computerized clinical laboratory database at GHC. Cox proportional hazards regression was used to calculate hazard ratios (HR, 95% CI) for dementia and AD associated with quartiles of TC and HDL levels. Results: Of the 2,356 eligible participants, 2,141 had at least one serum TC measure prior to the initial enrollment. Using the lowest TC quartiles as the reference group, the HR in the highest TC quartiles was not significantly elevated for dementia (1.16, 0.81 to 1.67) or for AD (1.00, 0.61 to 1.62) after adjusting for age, sex, education, baseline cognition, vascular comorbidities, body mass index, and lipid-lowering agent use. Serum HDL showed a similar lack of significant association with risk of dementia or AD. Models that included the presence of one or more APOE-ε4 alleles showed a typical association of ε4 with AD risk. This association was not materially modified by inclusion of TC level. Conclusion: The data do not support an association between serum total cholesterol or high density lipoprotein in late life and subsequent risk of dementia or Alzheimer disease (AD). The increased risk of AD with APOE-ε4 is probably not mediated by serum total cholesterol levels.

AB - Objectives: To examine the association of serum total cholesterol (TC) and high density lipoprotein (HDL) levels and subsequent incidence of dementia and Alzheimer disease (AD) in a population-based cohort study. Methods: A cohort of cognitively intact persons, aged 65 and older, was randomly selected from Group Health Cooperative (GHC), a large health maintenance organization, and was assessed biennially for dementia. Premorbid levels of TC and HDL were obtained from a computerized clinical laboratory database at GHC. Cox proportional hazards regression was used to calculate hazard ratios (HR, 95% CI) for dementia and AD associated with quartiles of TC and HDL levels. Results: Of the 2,356 eligible participants, 2,141 had at least one serum TC measure prior to the initial enrollment. Using the lowest TC quartiles as the reference group, the HR in the highest TC quartiles was not significantly elevated for dementia (1.16, 0.81 to 1.67) or for AD (1.00, 0.61 to 1.62) after adjusting for age, sex, education, baseline cognition, vascular comorbidities, body mass index, and lipid-lowering agent use. Serum HDL showed a similar lack of significant association with risk of dementia or AD. Models that included the presence of one or more APOE-ε4 alleles showed a typical association of ε4 with AD risk. This association was not materially modified by inclusion of TC level. Conclusion: The data do not support an association between serum total cholesterol or high density lipoprotein in late life and subsequent risk of dementia or Alzheimer disease (AD). The increased risk of AD with APOE-ε4 is probably not mediated by serum total cholesterol levels.

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