Ma Chaoran, Yin Zhaoxue, Zhu Pengfei, Luo Jiesi, Shi Xiaoming, Gao Xiang
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA.
Division of Chronic Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
Mol Neurodegener. 2017 Mar 7;12(1):24. doi: 10.1186/s13024-017-0167-y.
Previous studies regarding the lipid-cognition relation in older adults are limited and have generated mixed results. We thus examined whether higher blood cholesterol concentrations were associated with faster cognitive decline in a community-based longitudinal study of Chinese elderly.
The study included 1,159 Chinese adults aged over 60 years (women: 48.7%, mean age: 79.4 years), who were free of dementia, Parkinson disease and stroke at the baseline. Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), were assessed at the baseline. Global cognitive functions were assessed using the Chinese Mini-Mental State Examination (MMSE) at in 2009, 2012 and 2014. Association between blood cholesterol and repeated cognitive function was analyzed with linear mixed models, adjusting for sociodemographic information, behavior and lifestyle, depression symptoms, physical examination, hypertension, and laboratory indexes.
Higher baseline TC and LDL-C concentrations were significantly associated with greater cognitive decline. Adjusted mean difference in cognitive decline rate, comparing two extreme quartiles, was 0.28 points (MMSE score) per year (95% confident interval (CI): -0.54,-0.02; P-trend = 0.005) for TC and 0.42 points per year (95% CI: -0.69, -0.16; P-trend = 0.006) for LDL-C. In a subgroup analysis, the associations between all lipids and cognitive decline appeared to be more pronounced among individuals aged 100 years or older (n = 90), relative to others.
Higher blood concentrations of TC and LDL-C in late-life were associated with faster global cognitive decline.
以往关于老年人脂质与认知关系的研究有限，且结果不一。因此，我们在一项针对中国老年人的社区纵向研究中，探讨了较高的血胆固醇浓度是否与认知功能更快衰退相关。
该研究纳入了1159名60岁以上的中国成年人（女性占48.7%，平均年龄79.4岁），这些人在基线时无痴呆、帕金森病和中风。在基线时评估总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）的血浓度。在2009年、2012年和2014年使用中文版简易精神状态检查表（MMSE）评估整体认知功能。采用线性混合模型分析血胆固醇与重复认知功能之间的关联，并对社会人口学信息、行为和生活方式、抑郁症状、体格检查、高血压和实验室指标进行校正。
较高的基线TC和LDL-C浓度与更大的认知衰退显著相关。比较两个极端四分位数，TC导致的认知衰退率校正后平均差异为每年0.28分（MMSE评分）（95%置信区间（CI）：-0.54，-0.02；P趋势=0.005），LDL-C为每年0.42分（95%CI：-0.69，-0.16；P趋势=0.006）。在亚组分析中，相对于其他人群，所有脂质与认知衰退之间的关联在100岁及以上的个体（n=90）中似乎更为明显。
晚年血TC和LDL-C浓度较高与整体认知功能衰退更快相关。
