Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Age Ageing. 2021 Feb 26;50(2):472-479. doi: 10.1093/ageing/afaa140.
the association between cholesterol profiles and risk of cognitive decline among older adults was inconclusive.
to examine the association between cholesterol profiles and risk of cognitive decline in older adults with or without vascular risk factors (VRFs) in the prospective phase of the Shanghai Aging Study.
a prospective community-based cohort study.
Shanghai, China.
we prospectively followed 1,556 dementia-free participants aged ≥60 years with a baseline cholesterol profile for 5.2 years on average. Participants with at least one of obesity, diabetes, hypertension, stroke, and coronary artery disease were categorised to the VRFs group, and those free of any VRFs were categorised to the non-VRFs group.
total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol in serum were measured at baseline. At follow-up, consensus diagnosis of incident dementia and Alzheimer's disease (AD) were established based on medical, neurological, and neuropsychological examinations. Cox regression was used to assess the association between cholesterol and incident dementia/AD; multivariate linear regression was used to examine the relationship between cholesterol and an annual rate of Mini Mental State Examination (MMSE) score decline in participants with or without VRFs.
among VRFs-free participants, TC (HR 0.62, 95%CI 0.40-0.95) and LDL-C (HR 0.47, 95%CI 0.28-0.80) were inversely associated with incident dementia, LDL-C was inversely associated with incident AD (HR 0.50, 95%CI 0.28-0.90). A significant correlation was found between incremental TC (β = 0.08), LDL-C (β = 0.09), and a slower annual decline of MMSE score.
effect of cholesterol on cognitive decline may be modified by VRFs.
胆固醇谱与老年人认知能力下降风险之间的关联尚无定论。
在上海老龄化研究的前瞻性阶段，检查胆固醇谱与伴有或不伴有血管危险因素 (VRFs) 的老年人认知能力下降风险之间的关系。
一项前瞻性的基于社区的队列研究。
中国上海。
我们前瞻性地随访了 1556 名无痴呆症、年龄≥60 岁的参与者，他们的基线胆固醇谱平均随访了 5.2 年。至少有肥胖、糖尿病、高血压、中风和冠心病之一的参与者被归类为 VRFs 组，没有任何 VRFs 的参与者被归类为非 VRFs 组。
在基线时测量血清中的总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL-C) 和高密度脂蛋白胆固醇。在随访期间，根据医学、神经学和神经心理学检查，确定新发痴呆症和阿尔茨海默病 (AD) 的共识诊断。Cox 回归用于评估胆固醇与新发痴呆症/AD 之间的关联；多元线性回归用于检查 VRFs 组和非 VRFs 组参与者中胆固醇与每年 Mini Mental State Examination (MMSE) 评分下降率之间的关系。
在无 VRFs 的参与者中，TC (HR 0.62, 95%CI 0.40-0.95) 和 LDL-C (HR 0.47, 95%CI 0.28-0.80) 与新发痴呆症呈负相关，LDL-C 与新发 AD 呈负相关 (HR 0.50, 95%CI 0.28-0.90)。TC (β=0.08) 和 LDL-C (β=0.09) 的增量与 MMSE 评分每年下降速度较慢之间存在显著相关性。
胆固醇对认知能力下降的影响可能受到 VRFs 的调节。
