Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.
Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, P.R. China.
J Alzheimers Dis. 2023;95(2):625-640. doi: 10.3233/JAD-230422.
The association between dietary or serum cholesterol and cognitive performance in older adults has not been well-established.
This study aimed to investigate the potential association between dietary or serum cholesterol and cognitive performance in the elderly population.
A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014. Diet and supplement cholesterol was estimated based on two non-consecutive 24-hour dietary recalls. Cognitive function was assessed using various statistical tests. Poor cognitive performance was defined as scores below the lowest quartile within age groups. Regression models were adjusted for demographic factors, and subgroup analyses were performed for non-Hispanic White (NHW) and non-Hispanic Black (NHB) individuals.
Among 759 participants aged 60 years and above, dietary cholesterol was only associated with dietary saturated fatty acids and serum high-density lipoprotein cholesterol. There was no evidence of an association between dietary cholesterol and cognitive function, except for NHB individuals, where dietary cholesterol showed a positive correlation with cognitive function. In the overall sample and NHW participants, there were consistent positive associations between serum total cholesterol and cognitive performance across statistical tests, while such associations were rare among NHB individuals. Although not statistically significant, NHB individuals had higher dietary/supplementary/total cholesterol intake compared with NHW individuals.
Within the normal range, increasing serum cholesterol may be a potential factor to prevent or relieve cognitive dysfunction. However, ethnic differences should be taken into account when considering the association between cholesterol and cognitive performance.
饮食或血清胆固醇与老年人认知表现之间的关系尚未得到很好的确立。
本研究旨在探讨老年人饮食或血清胆固醇与认知表现之间的潜在关联。
使用 2011-2012 年和 2013-2014 年国家健康和营养调查（NHANES）的数据进行横断面分析。根据两次非连续的 24 小时膳食回忆来估计饮食和补充胆固醇。使用各种统计测试评估认知功能。认知表现差定义为年龄组内得分低于最低四分位数。回归模型调整了人口统计学因素，并对非西班牙裔白人和非西班牙裔黑人进行了亚组分析。
在 759 名 60 岁及以上的参与者中，饮食胆固醇仅与饮食饱和脂肪酸和血清高密度脂蛋白胆固醇有关。除了非西班牙裔黑人，饮食胆固醇与认知功能之间没有关联的证据，而在非西班牙裔黑人中，饮食胆固醇与认知功能呈正相关。在总样本和非西班牙裔白人参与者中，血清总胆固醇与认知表现之间存在一致的正相关，而在非西班牙裔黑人中这种相关性很少见。尽管没有统计学意义，但与非西班牙裔白人相比，非西班牙裔黑人的饮食/补充/总胆固醇摄入量较高。
在正常范围内，增加血清胆固醇可能是预防或缓解认知功能障碍的潜在因素。然而，在考虑胆固醇与认知表现之间的关系时，应该考虑到种族差异。
