Key result
Highest total cholesterol linked to ~9% greater Alzheimer's disease risk in older adults.
Why the study?
Clinical guidelines focus on managing vascular risk factors for the primary prevention of Alzheimer disease, but the link between these factors and Alzheimer disease in older adults remains unclear.
Are vascular risk factors associated with the incidence of Alzheimer's disease in older adults?
Cohort (n=178,586)
Are vascular risk factors associated with the incidence of Alzheimer's disease in older adults?
Hazard Ratio: 1.089 (95% CI 1.025–1.156)
Multiple vascular risk factors, including lipid profiles and blood pressure components, are significantly associated with the development of Alzheimer's disease in older adults.
Supports lipid monitoring for dementia risk in older adults; observational association leaves open whether lowering cholesterol prevents Alzheimer's disease.
Background: The clinical guidelines related to the primary prevention of Alzheimer’s disease (AD) have focused on the management of vascular risk factors. However, the link between vascular risk factors and AD in older adults remains unclear. This study aimed to determine the association between vascular risk factors and subsequent AD in 178,586 older adults (age: ≥65 years). Methods: Participants were recruited from 2009 through 2010 and followed up for 6 years. We assessed various vascular risk factors (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], fasting glucose [FG], systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP] and body mass index [BMI]) and their association with AD incidence, categorizing each vascular factor using current clinical guidelines. Results: AD was observed in 6.0% of participants at follow-up. All lipid profiles (TC, LDL-C, HDL-C, TG) were positively associated with the risk of AD. SBP and PP were in negative associations with AD, and DBP was positively associated with AD. BMI exhibited a negative association with AD incidence. We found no significant association between FG and AD risk. The sex difference was observed to have effects on vascular risk factors.Conclusions: In this study, we comprehensively investigated the association between eight vascular risk factors and the risk of incident AD. Our findings suggest that multiple vascular risk factors are related to the development of AD in older adults. These results can help inform future guidelines for reducing AD risk.
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Lee et al. (2020) conducted a cohort in Alzheimer's disease (n=178,586). Vascular risk factors (including total cholesterol, LDL-C, HDL-C, triglycerides, blood pressure, fasting glucose, and BMI) vs. Referent levels based on current clinical guidelines was evaluated on Incident Alzheimer's disease (HR 1.089, 95% CI 1.025-1.156). Highest levels of total cholesterol (≥240 mg/dL) were associated with an increased risk of incident Alzheimer's disease (HR 1.089) compared to referent levels (<200 mg/dL) in older adults.
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