1. LDL cholesterol may have protective properties for brain health in older age: Do we need to re‐think current guidelines?: Epidemiology / Risk and protective factors in MCI and dementia.
- Author
-
Kuszewski, Julia C, Zaw, Jay Jay Thaung, Wong, Rachel HX, and Howe, Peter RC
- Abstract
Background: Elevated low‐density lipoprotein (LDL) cholesterol is a major contributor to cardiovascular diseases (CVD), which are associated with accelerated cognitive decline. However, recent studies suggest LDL cholesterol to be protective against cognitive decline in the very elderly (>85 years). We investigated associations between serum LDL cholesterol, cerebrovascular function and cognition in community‐dwelling adults aged 50‐80 years, testing for differences between mid‐life (50‐64 years) and older age (65‐80 years). Method: Our cross‐sectional analysis used baseline assessments from 236 older adults (78% female, age: 65±0.5 years, BMI: 28.2±0.3 kg/m2, LDL: 3.7±0.1 mmol/L) participating in two intervention trials investigating effects of vasoactive nutrients on cognition, cerebrovascular function and cardiometabolic biomarkers. None were taking statin medication. Assessments included a battery of 10 neuropsychological tests, transcranial Doppler ultrasound to measure cerebral blood flow velocity (BFV) and cerebrovascular resistance index (CVRi), clinic blood pressure and a fasted venous blood sample to measure serum cholesterol. Result: LDL cholesterol correlated with Framingham CVD risk in mid‐life (R=0.360, P<0.001), but not in older adults (R=‐0.124, P=0.174). In adults aged >65 years (n=122), higher LDL cholesterol correlated with higher mean BFV (R=0.255, P=0.009), lower CVRi (R=‐0.266, P=0.006) and higher overall cognitive performance (R=0.228, P=0.011). The latter two were inversely correlated (R=‐0.154, P=0.024, age adjusted). Conclusion: LDL cholesterol appears to have a positive association with cerebrovascular and cognitive functions in advanced age; hence, pharmacologically reducing LDL cholesterol to <2mmol/L as currently recommended might not be beneficial for this age group. Further research is warranted to establish optimal LDL cholesterol levels in the elderly. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF