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Variability in Total Cholesterol, LDL Cholesterol Linked to Dementia

Higher variability also linked to cognitive impairment with no dementia and with faster decline in global cognition, episodic memory

By Elana Gotkine HealthDay Reporter

MONDAY, Feb. 3, 2025 (HealthDay News) — Variability in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) is associated with dementia and cognitive impairment, according to a study published online Jan. 27 in Neurology.

Zhen Zhou, Ph.D., from Monash University in Melbourne, Australia, and colleagues examined the association between year-to-year intraindividual lipid variability and the subsequent risk for cognitive decline and dementia in community-dwelling older adults in the ASPirin in Reducing Events in the Elderly randomized trial of aspirin. This post-hoc analysis included participants with lipid levels measured at baseline and in years 1, 2, and 3 and quantified year-to-year variability in TC, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides.

The analysis included 9,846 individuals. The researchers identified 509 incident dementia events and 1,790 cognitive impairment with no dementia (CIND) events during a median follow-up of 5.8 and 5.4 years after assessment of variability. Comparing the highest and lowest quartiles of TC and LDL-C variability, respectively, the hazard ratios were 1.60 and 1.48 for dementia and 1.23 and 1.27 for CIND. Associations were also seen for higher TC and LDL-C variability with faster decline in global cognition, episodic memory, psychomotor speed, and the composite score for changes in four cognitive function domains. There was no strong evidence for an association of HDL-C and triglyceride variability with dementia and cognitive change.

“These results suggest that fluctuating cholesterol, measured annually, may be a new biomarker for identifying people at risk of dementia, providing more information than the actual cholesterol levels measured at a single time point,” Zhou said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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