Roberts Laboratory for Neurodegenerative Disease Research, Sun Health Research Institute, Sun City, Ariz., USA.
Neurodegener Dis. 2010;7(1-3):183-6. doi: 10.1159/000295660. Epub 2010 Mar 12.
We reported a significant 67% reduction in the hazard risk of incident Alzheimer's disease (AD) with elective statin use in the AD Anti-inflammatory Prevention Trial (ADAPT), without a reduction in risk of incident mild cognitive impairment (MCI).
To assess if cholesterol levels are associated with cognitive performance and determine if statin use alters cognitive performance after onset of MCI.
Fractionated cholesterol levels, neurological and cognitive status were evaluated annually. Comparisons of non-LLA (lipid-lowering agent) users or statin-LLA users were performed blind to the ADAPT medication randomization. Pearson's correlations were validated using a time-dependent linear mixed model.
The MMSE performance significantly declined over time in non-LLA users, and, after adjusting for this, a significant positive correlation between MMSE and HDL was identified (p = 0.0002). A negative correlation between total and LDL cholesterol, and immediate and delayed recall of the Rivermead paragraph was significant (total cholesterol, p < 0.003; LDL, p < 0.02). Pilot data suggest a positive signal on delayed recall of both the Hopkins word list and Rivermead paragraph with deterioration in the non-LLA users and improvement in the statin users after conversion to MCI.
Cholesterol levels may be associated with differential performance on the MMSE and measures of learning or memory. The trend for improved delayed recall in statin users with MCI compared to non-LLA users with MCI may have contributed to the reduced hazards risk of incident AD without reducing the risk of MCI.
我们报告称，在 AD 抗炎预防试验（ADAPT）中，选择性使用他汀类药物可显著降低阿尔茨海默病（AD）发病的风险，降低 67%，而不会降低轻度认知障碍（MCI）发病的风险。
评估胆固醇水平是否与认知表现相关，并确定他汀类药物是否会改变 MCI 发病后的认知表现。
每年评估分段胆固醇水平、神经和认知状态。非 LLA（降脂药）使用者或他汀类药物使用者与 ADAPT 药物随机分组进行比较。采用时间依赖性线性混合模型验证 Pearson 相关性。
非 LLA 使用者的 MMSE 表现随时间显著下降，调整后发现 MMSE 与高密度脂蛋白（HDL）呈显著正相关（p = 0.0002）。总胆固醇和 LDL 胆固醇与即时和延迟回忆 Rivermead 段落之间存在显著负相关（总胆固醇，p < 0.003；LDL，p < 0.02）。初步数据表明，在非 LLA 使用者中，Hopkins 单词列表和 Rivermead 段落的延迟回忆出现恶化，他汀类药物使用者的延迟回忆有所改善，这一信号呈阳性。
胆固醇水平可能与 MMSE 以及学习或记忆的测量结果相关。与非 LLA 使用者相比，他汀类药物使用者在 MCI 中的延迟回忆改善的趋势可能导致 AD 发病的风险降低，而不会降低 MCI 的风险。
