Midlife cholesterol levels predict Alzheimer disease with ASCVD
Cardiovascular risk factors and glucose tolerance in midlife and risk of cognitive disorders in old age Up to a 49-year follow-up of the Helsinki Businessmen StudyLiterature - Rantanen K, Strandberg AY., Salomaa VV, et al. - Ann Med. 2017 Feb 2:1-30
- AD-ASCVD patients had significantly higher cholesterol at baseline.
- APOE Ɛ4 allele was present in 31.5% of a subcohort of men without dementia and 42.9, 51.4 and 45.5% in a subcohort of patients with pure AD, AD-ASCVD and VD, respectively (P=0.06).
- In this same subcohort, the mini-mental state examination (MMSE) scores were 28.5, 26.2. 27.4 and 25.8 among old-age survivors, pure AD, AD-ASCVD and VD groups, respectively (P<0.001).
- Pure AD men had the highest use of AD drugs (71%). VD patients had highest use of hypertension and diabetes drugs, which moreover, was lower in pure AD than in men without dementia.
- Smoking, BMI, systolic BP and cholesterol levels at baseline were not associated with pure AD or VD, but risk of AD-ASCVD was significantly predicted by midlife cholesterol levels in which high cholesterol (≥6.5 mmol/L) increased the risk by 67% as compared to low levels. HR per standard deviation was 1.24 (95% CI 1.04-1.47).
- One-hour glucose (adjusted for age and smoking) significantly predicted mortality without dementia but not with any type of dementia.
In this study with a long-term follow-up, pure AD (without ASCVD) was not associated with cholesterol levels, blood pressure, glucose tolerance of diabetes, whereas AD with ASCVD was significantly associated with midlife cholesterol levels.