Association between total cholesterol to HDL-cholesterol ratio and Probable dementia among older people: A cross-sectional study in Southwestern Uganda

Background Dementia is a condition characterized by a decline in cognitive abilities that exceeds what could normally be anticipated due to the natural process of ageing. This study assessed the association of serum lipoproteins with probable dementia among older people in Rukiga District, South-western Uganda. Methods This was a community-based cross-sectional study in Rukiga District, South-western Uganda. The study was conducted from February 15, 2025 to March, 29, 2025 among 272 individuals 60 years of age and above who were selected through multistage sampling. Data were collected using a researcher-administered questionnaire supplemented with information from participant’s medical records and a brief community screening instrument for dementia. Anthropometric measurements were taken and a blood sample was drawn for laboratory measurement of serum lipoproteins. Results Of 272 participants, 45 (16.5%) had probable dementia. Participants with probable dementia had significantly higher total cholesterol levels (median: 172 mg/dL, IQR: 140–199) compared to those without probable dementia (156 mg/dL, IQR: 134–183, p=0.019). In multivariable analysis, total cholesterol to HDL-cholesterol (TC/HDL-C) (aOR: 1.13, 95% CI: 1.01–1.25, p=0.027), age;(aOR: 1.27, 95% CI: 1.16–1.39, p<0.001) and low physical activity; (aOR: 3.55, 95% CI: 1.04–12.08, p=0.042) ratio were significantly associated with probable dementia. Conclusions Probable dementia was relatively common among community-dwelling older adults in Southwestern Uganda. TC/HDL-C ratio, advancing age, and low physical activity levels are potentially associated with probable dementia. We recommend future studies incorporating standardized clinical diagnostic criteria for dementia to confirm these findings.