TY - JOUR
T1 - Serum cholesterol and risk of Alzheimer disease
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, J. C.S.
AU - McCormick, W.
AU - Bowen, J. D.
AU - Teri, L.
AU - Schellenberg, G. D.
AU - Larson, E. B.
N1 - Funding Information:
Supported in part by grants AG20020, AG06781, AG16976, and AG05136 from the National Institute of Aging, National Institutes of Health, Bethesda, MD.
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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U2 - 10.1212/01.wnl.0000178989.87072.11
DO - 10.1212/01.wnl.0000178989.87072.11
M3 - Article
C2 - 16217057
AN - SCOPUS:26444569232
VL - 65
SP - 1045
EP - 1050
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 7
ER -