Fluctuating Levels of Cholesterol Associated With an Increased Risk of Dementia

Brain Inflammation Dementia Glowing

New research suggests that older individuals with fluctuating levels of cholesterol and triglycerides may have a higher risk of developing Alzheimer’s disease and related dementias compared to those with steady levels. While the study identified a correlation, it did not establish a causal relationship between fluctuating lipid levels and dementia, and further research is needed to understand this connection.

According to new research published in Neurology, the medical journal of the American Academy of Neurology, older individuals with fluctuating levels of cholesterol and triglycerides may be at a heightened risk of developing Alzheimer’s disease and related dementias compared to those with stable levels. It is important to note, however, that while the study identified a correlation, it did not establish that fluctuating levels of cholesterol and triglycerides are a direct cause of dementia.

“Prevention strategies for Alzheimer’s and related dementias are urgently needed,” said study author Suzette J. Bielinski, Ph.D., of the Mayo Clinic in Rochester, Minnesota. “Routine screenings for cholesterol and triglyceride levels are commonly done as part of standard medical care. Fluctuations in these results over time could potentially help us identify who is at greater risk for dementia, help us understand mechanisms for the development of dementia and ultimately determine whether leveling out these fluctuations could play a role in reducing dementia risk.”

Researchers used healthcare data to identify 11,571 people aged 60 or older who did not have a prior diagnosis of Alzheimer’s disease or dementia. Researchers looked at participants’ measurements of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL) on at least three different days in the five years before the start of the study.

Then researchers divided participants into five equal groups based on how much the measurements fluctuated. The lowest group had the least variation over time and the highest group had the most variation.

Participants were followed for an average of 13 years. During that time, 2,473 people developed Alzheimer’s disease or another form of dementia.

After adjusting for variables that could affect the risk of dementia including sex, race, education, and lipid-lowering treatments, researchers found for total cholesterol, participants in the highest group had a 19% increased risk of dementia compared to those in the lowest group. Of the 2,311 people in the highest group, 515 developed dementia compared to 483 of the 2,311 people in the lowest group. For triglycerides, those in the highest group had a 23% increased risk.

Researchers did not find a link between variations in LDL and HDL and an increased risk of dementia.

“It remains unclear why and how fluctuating levels of cholesterol and triglycerides are related to the risk of Alzheimer’s disease,” said Bielinski. “Further studies looking at the changes over time for this relationship are needed in order to confirm our results and potentially consider preventative strategies.”

Reference: “Association Between Fluctuations in Blood Lipid Levels Over Time With Incident Alzheimer Disease and Alzheimer Disease Related Dementias” by Ethan D. Moser, Sheila M. Manemann, Nicholas B. Larson, Jennifer L. St. Sauver, Paul Y. Takahashi, Michelle M. Mielke, Walter A. Rocca, Janet E. Olson, Véronique L. Roger, Alan T. Remaley, Paul A. Decker, Jill M. Killian and Suzette J. Bielinski, 5 July 2023, Neurology.
DOI: 10.1212/WNL.0000000000207595

A limitation of the study was researchers looked at Alzheimer’s disease and related dementias as a whole and did not differentiate between the types of dementia.

The study was supported by the National Heart, Lung and Blood Institute.

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