Association of Higher Levels of High-Density Lipoprotein Cholesterol in Elderly Individuals and Lower Risk of Late-Onset Alzheimer Disease

OBJECTIVE: To reexamine the association of lipid levels with Alzheimer disease (AD) using Cox proportional hazards models. DESIGN: Prospective cohort study. SETTING: Northern Manhattan, New York. PARTICIPANTS: One thousand one hundred thirty elderly individuals free of cognitive impairment at baseline. MAIN OUTCOME MEASURE: High-density lipoprotein cholesterol (HDL-C) levels. RESULTS: Higher levels of HDL-C (>55 mg/dL) were associated with a decreased risk of both probable and possible AD and probable AD compared with lower HDL-C levels (hazard ratio, 0.4; 95% confidence interval, 0.2-0.9; P = .03 and hazard ratio, 0.4; 95% confidence interval, 0.2-0.9; P = .03). In addition, higher levels of total and non-HDL-C were associated with a decreased risk of AD in analyses adjusting for age, sex, education, ethnic group, and APOE e4 genotype. CONCLUSION: High HDL-C levels in elderly individuals may be associated with a decreased risk of AD.