Table 5.
Cholesterol and relative risk of subsequent dementia
| Number of subjects | RR (95% CI) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Grade | Study | Age@Chol (years) | Follow-up (years) | Definition (mmol/L) | High | NL | All dementia | VaD | AD + VaD | AD |
| Mid-life cholesterol and relative risk of subsequent dementia | ||||||||||
| B1 | Notkola et al. 1998 [33]; Finnish cohorts (n = 444) | 40-59 (men) | 30 | Chol ≥6.5 mmol/L averaged over 4 visits | 184 | 260 | 3.1 (1.2, 8.5)a | |||
| B1 | Kalmijn et al. 2000 [36]; HAAS (n = 3,734) | 52.7 ± 4.7 (men) | 27 | Per 1 SD = 0.92 | 1.10 (0.95, 1.26) | |||||
| B1 | Kivipelto et al. 2002 [35]; FIN-MONICA (n = 2,293) | 50.2 ± 6.0 | 21 | Chol ≥6.5 mmol/L | NA | NA | 2.6 (1.2, 6.0)b | 2.8 (1.2, 6.7)b | ||
| Late-life cholesterol and relative risk of subsequent dementia | ||||||||||
| B1 | Tan et al. 2003 [34]; 1988 Framingham (n = 1,026) | 76.1 | 12 | Per 0.3 mmol/L average chol over previous 15 visits (1950-1980) | 0.95 (0.87, 1.04)c | |||||
| Per 0.3 mmol/L cholesterol at visit 20 (1988) | 0.97 (0.90, 1.05)c | |||||||||
| B1 | Reitz et al. 2004 [38]; 1992 WHICAP - prospective (n = 1,168) | 78.4 ± 6.2 | 4.8 ± 2.9 | Chol ≥5.9 mmol/L | 291 | 877 | 1.61 (0.7, 3.74)d 1.05 (0.42, 2.60)e |
0.55 (0.32, 0.95)d 0.48 (0.26, 0.86)e |
||
| LDLc ≥3.67 mmol/L | 2.45 (1.05, 5.7)d | 0.88 (0.51, 1.51)d | ||||||||
| 2.07 (0.85, 5.06)e | 0.80 (0.46, 1.40)e | |||||||||
| B2 | Li et al. 2005 [37]; Group Health Cooperative (n = 2,141) | ≥65 | 5.6 ± 1.8 | Triglyceride >254 mg/dL HDLc <1.2 mmol/L |
1.16 (0.81,1.67)f 1.04 (0.69, 1.55)f |
1.0 (0.71, 2.15)f 1.23 (0.71, 2.15)f |
||||
| B1 | Mielke et al. 2005 [40]; Göteborg (n = 973) | 70 | 18 | Chol >8.0 mmol/L | 56 | 326 | 0.31 (0.11, 0.85)g | |||
| B1 | Reitz et al. 2010 [39]; 1999 WHICAP (n = 1,130) | 75.7 ± 6.3 | 3.96 | HDLc >1.42 mmol/L | 284 | 846 | 0.4 (0.2, 0.9)h | |||
| 3.1 < LDLc < 3.7 mmol/L | 283 | 847 | 0.5 (0.2, 0.9)h | |||||||
Note that 1 mmol/L cholesterol = 38.6 mg/dl cholesterol. aAdjusted for age and APOE4. bAdjusted for age and APOE4, education, sex, smoking, alcohol. cAdjusted for age, sex, APOE4, coronary artery disease, body mass index, and lipid-lowering medication. dAdjusted for sex, age, education and race. eAdjusted for body mass index, APOE4, diabetes, heart disease, hyperten sion. fAdusted for age, sex, education, Cognitice Abilities Screening Instrument, body mass index, hypertension, coronary artery disease, cerebrovascular disease, diabetes mellitus. gAdjusted for body mass index, diastolic blood pressure, sex, education, smoking. hAdjusted for age, sex, education, ethnic group APOE ε4 genotype, diabetes, hypertension, heart disease, body mass index, lipid-lowering treatment. Entries in bold indicate significant relative risk (RR) ratios. Age@Chol, age of subject when cholesterol was measured; AD, Alzheimer's disease; Chol, cholesterol; FIN-MONICA, Finnish part of Multinational Monitoring of Trends and Determinants in Cardiovascular Disease; HAAS, Honolulu Asia Aging Study; HDLc, high-density lipoprotein cholesterol; LDLc, low-density lipoprotein cholesterol; NA, not available; NL, normal; SD, standard deviation; VaD, vascular dementia; WHICAP, Washington Heights-Inwood Columbia Aging Project.