Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later

Alina Solomon, Miia Kivipelto, Benjamin Wolozin, Jufen Zhou, Rachel Whitmer

Research output: Contribution to journalArticle

279 Citations (Scopus)

Abstract

Aims: To investigate midlife cholesterol in relation to Alzheimer's disease (AD) and vascular dementia (VaD) in a large multiethnic cohort of women and men. Methods: The Kaiser Permanente Northern California Medical Group (healthcare delivery organization) formed the database for this study. The 9,844 participants underwent detailed health evaluations during 1964-1973 at ages 40-45 years; they were still members of the health plan in 1994. AD and VaD were ascertained by medical records between 1 January 1994 and 1 June 2007. Cox proportional hazards models - adjusted for age, education, race/ethnic group, sex, midlife diabetes, hypertension, BMI and late-life stroke - were conducted. Results: In total, 469 participants had AD and 127 had VaD. With desirable cholesterol levels (<200 mg/dl) as a reference, hazard ratios (HR) and 95% CI for AD were 1.23 (0.97-1.55) and 1.57 (1.23-2.01) for borderline (200-239 mg/dl) and high cholesterol (≥240 mg/dl), respectively. HR and 95% CI for VaD were 1.50 (1.01-2.23) for borderline and 1.26 (0.82-1.96) for high cholesterol. Further analyses for AD (cholesterol quartiles, 1st quartile reference) indicated that cholesterol levels >220 mg/dl were a significant risk factor: HR were 1.31 (1.01-1.71; 3rd quartile, 221-248 mg/dl) and 1.58 (1.22-2.06; 4th quartile, 249-500 mg/dl). Conclusion: Midlife serum total cholesterol was associated with an increased risk of AD and VaD. Even moderately elevated cholesterol increased dementia risk. Dementia risk factors need to be addressed as early as midlife, before underlying disease(s) or symptoms appear.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalDementia and Geriatric Cognitive Disorders
Volume28
Issue number1
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Fingerprint

Vascular Dementia
Alzheimer Disease
Cholesterol
Serum
Dementia
Health
Hypercholesterolemia
Proportional Hazards Models
Ethnic Groups
Medical Records
Stroke
Organizations
Databases
Hypertension
Delivery of Health Care
Education

Keywords

  • Alzheimer's dementia
  • Cholesterol
  • Dementia
  • Epidemiology
  • Vascular dementia

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cognitive Neuroscience
  • Psychiatry and Mental health

Cite this

Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later. / Solomon, Alina; Kivipelto, Miia; Wolozin, Benjamin; Zhou, Jufen; Whitmer, Rachel.

In: Dementia and Geriatric Cognitive Disorders, Vol. 28, No. 1, 01.08.2009, p. 75-80.

Research output: Contribution to journalArticle

Solomon, Alina ; Kivipelto, Miia ; Wolozin, Benjamin ; Zhou, Jufen ; Whitmer, Rachel. / Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later. In: Dementia and Geriatric Cognitive Disorders. 2009 ; Vol. 28, No. 1. pp. 75-80.
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abstract = "Aims: To investigate midlife cholesterol in relation to Alzheimer's disease (AD) and vascular dementia (VaD) in a large multiethnic cohort of women and men. Methods: The Kaiser Permanente Northern California Medical Group (healthcare delivery organization) formed the database for this study. The 9,844 participants underwent detailed health evaluations during 1964-1973 at ages 40-45 years; they were still members of the health plan in 1994. AD and VaD were ascertained by medical records between 1 January 1994 and 1 June 2007. Cox proportional hazards models - adjusted for age, education, race/ethnic group, sex, midlife diabetes, hypertension, BMI and late-life stroke - were conducted. Results: In total, 469 participants had AD and 127 had VaD. With desirable cholesterol levels (<200 mg/dl) as a reference, hazard ratios (HR) and 95{\%} CI for AD were 1.23 (0.97-1.55) and 1.57 (1.23-2.01) for borderline (200-239 mg/dl) and high cholesterol (≥240 mg/dl), respectively. HR and 95{\%} CI for VaD were 1.50 (1.01-2.23) for borderline and 1.26 (0.82-1.96) for high cholesterol. Further analyses for AD (cholesterol quartiles, 1st quartile reference) indicated that cholesterol levels >220 mg/dl were a significant risk factor: HR were 1.31 (1.01-1.71; 3rd quartile, 221-248 mg/dl) and 1.58 (1.22-2.06; 4th quartile, 249-500 mg/dl). Conclusion: Midlife serum total cholesterol was associated with an increased risk of AD and VaD. Even moderately elevated cholesterol increased dementia risk. Dementia risk factors need to be addressed as early as midlife, before underlying disease(s) or symptoms appear.",
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AU - Solomon, Alina

AU - Kivipelto, Miia

AU - Wolozin, Benjamin

AU - Zhou, Jufen

AU - Whitmer, Rachel

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N2 - Aims: To investigate midlife cholesterol in relation to Alzheimer's disease (AD) and vascular dementia (VaD) in a large multiethnic cohort of women and men. Methods: The Kaiser Permanente Northern California Medical Group (healthcare delivery organization) formed the database for this study. The 9,844 participants underwent detailed health evaluations during 1964-1973 at ages 40-45 years; they were still members of the health plan in 1994. AD and VaD were ascertained by medical records between 1 January 1994 and 1 June 2007. Cox proportional hazards models - adjusted for age, education, race/ethnic group, sex, midlife diabetes, hypertension, BMI and late-life stroke - were conducted. Results: In total, 469 participants had AD and 127 had VaD. With desirable cholesterol levels (<200 mg/dl) as a reference, hazard ratios (HR) and 95% CI for AD were 1.23 (0.97-1.55) and 1.57 (1.23-2.01) for borderline (200-239 mg/dl) and high cholesterol (≥240 mg/dl), respectively. HR and 95% CI for VaD were 1.50 (1.01-2.23) for borderline and 1.26 (0.82-1.96) for high cholesterol. Further analyses for AD (cholesterol quartiles, 1st quartile reference) indicated that cholesterol levels >220 mg/dl were a significant risk factor: HR were 1.31 (1.01-1.71; 3rd quartile, 221-248 mg/dl) and 1.58 (1.22-2.06; 4th quartile, 249-500 mg/dl). Conclusion: Midlife serum total cholesterol was associated with an increased risk of AD and VaD. Even moderately elevated cholesterol increased dementia risk. Dementia risk factors need to be addressed as early as midlife, before underlying disease(s) or symptoms appear.

AB - Aims: To investigate midlife cholesterol in relation to Alzheimer's disease (AD) and vascular dementia (VaD) in a large multiethnic cohort of women and men. Methods: The Kaiser Permanente Northern California Medical Group (healthcare delivery organization) formed the database for this study. The 9,844 participants underwent detailed health evaluations during 1964-1973 at ages 40-45 years; they were still members of the health plan in 1994. AD and VaD were ascertained by medical records between 1 January 1994 and 1 June 2007. Cox proportional hazards models - adjusted for age, education, race/ethnic group, sex, midlife diabetes, hypertension, BMI and late-life stroke - were conducted. Results: In total, 469 participants had AD and 127 had VaD. With desirable cholesterol levels (<200 mg/dl) as a reference, hazard ratios (HR) and 95% CI for AD were 1.23 (0.97-1.55) and 1.57 (1.23-2.01) for borderline (200-239 mg/dl) and high cholesterol (≥240 mg/dl), respectively. HR and 95% CI for VaD were 1.50 (1.01-2.23) for borderline and 1.26 (0.82-1.96) for high cholesterol. Further analyses for AD (cholesterol quartiles, 1st quartile reference) indicated that cholesterol levels >220 mg/dl were a significant risk factor: HR were 1.31 (1.01-1.71; 3rd quartile, 221-248 mg/dl) and 1.58 (1.22-2.06; 4th quartile, 249-500 mg/dl). Conclusion: Midlife serum total cholesterol was associated with an increased risk of AD and VaD. Even moderately elevated cholesterol increased dementia risk. Dementia risk factors need to be addressed as early as midlife, before underlying disease(s) or symptoms appear.

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KW - Cholesterol

KW - Dementia

KW - Epidemiology

KW - Vascular dementia

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