Table 4.
The adjusted association between a 10 mg/dL‡ change in plasma lipids at Visit 2 and 20-year cognitive decline in cognitive test z-scores by race or APOE ε4 status where there was support for effect measure modification
| Difference in 20-year cognitive change* | |||||
|---|---|---|---|---|---|
| White | Black | ||||
| Estimate (95% CI) | P-value | Estimate (95% CI) | P-value | P-value for interaction | |
| Total cholesterol (n=12,232) | (n=9,496) | (n=2,736) | |||
| Summary Z-score | −0.011 (−0.017, −0.006) | 0.0001 | 0.006 (−0.004, 0.016) | 0.24 | 0.003 |
| DWRT Z-score | −0.014 (−0.023, −0.005) | 0.003 | 0.004 (−0.012, 0.020) | 0.62 | 0.05 |
| DSST Z-score | −0.009 (−0.013, −0.005) | <0.0001 | 0.005 (−0.002, 0.012) | 0.18 | 0.0005 |
| LDL-c (n=12,017) | (n=9,310) | (n=2,707 | |||
| Summary Z-score | −0.008 (−0.014, −0.002) | 0.007 | 0.009 (−0.001, 0.020) | 0.07 | 0.004 |
| DWRT Z-score | −0.012 (−0.022, −0.002) | 0.02 | 0.009 (−0.007, 0.026) | 0.27 | 0.03 |
| DSST Z-score | −0.007 (−0.011, −0.002) | 0.002 | 0.003 (−0.005, 0.010) | 0.49 | 0.03 |
| No APOE ε4 | At least one APOE ε4 | ||||
| Estimate (95% CI) | P-value | Estimate (95% CI) | P-value | P-value for interaction | |
| Total cholesterol (n=12,232) | (n=8,526) | (n=3,706) | |||
| DWRT Z-score | −0.001 (−0.011, 0.008) | 0.77 | −0.030 (−0.044, −0.015) | 0.0001 | 0.001 |
| LDL-c (n=12,017) | (n=8,378) | (n=3,639) | |||
| DWRT Z-score | 0.001 (−0.009, 0.011) | 0.86 | −0.024 (−0.040, −0.009) | 0.002 | 0.007 |
| Triglycerides† (n=12,151) | (n=8,476) | (n=3,675) | |||
| DWRT Z-score | −0.004 (−0.009, 0.002) | 0.17 | −0.013 (−0.021, −0.005) | 0.002 | 0.05 |
| WFT Z-score | −0.004 (−0.007, −0.001) | 0.004 | 0.002 (−0.003, 0.006) | 0.51 | 0.03 |
Abbreviations: CI, Confidence interval; DSST, Digit-Symbol Substitution Test; DWRT, Delayed Word Recall Test; LDL-c, low density lipoprotein cholesterol; HDL-c, high density lipoprotein cholesterol; WFT, word fluency test
Adjusted for baseline age, age squared, education, sex, race-center, APOE ε4 status, body mass index, alcohol use, smoking status, diabetes, hypertension, physical activity, health insurance status, adherence to a western dietary pattern, adherence to a prudent dietary pattern, and lipid-lowering medication use, including both their main effects and their interactions with time on study.
Within the range of 0 to 500mg/dL (0 to 5.65 mmol/L)
In mmol/L:Total cholesterol, LDL-c, HDL-c: per 0.26 mmol/L, Triglycerides: per 0.11 mmol/L higher