Serum cholesterol changes after midlife and late-life cognition -: Twenty-one-year follow-up study
Serum cholesterol changes after midlife and late-life cognition -: Twenty-one-year follow-up study
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DOI：
10.1212/01.wnl.0000256368.57375.b7
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发表时间：
2007-03-06
期刊：
影响因子：
9.9
通讯作者：
Kivipelto, M.
中科院分区：
文献类型：
--
作者：
Solomon, A.;Kareholt, I.;Kivipelto, M.
背景：纵向研究表明，中年时血清总胆固醇（TC）升高是痴呆/阿尔茨海默病的危险因素。TC在以后生活中的意义尚不清楚。目的：探讨中老年血清总胆固醇（TC）水平的变化及其与老年认知的关系。研究方法：心血管危险因素、衰老和痴呆研究的参与者来自于1972年、1977年、1982年或1987年的一项调查中随机的、基于人群的样本。经过平均21年的随访，1998年对1,449名年龄在65岁至79岁之间的人进行了重新检查。结果：大部分个体血清TC水平降低。中年高TC代表了以后生活中更严重的认知障碍的危险因素，并且对照组、轻度认知障碍组和痴呆组之间的值存在显著差异。复查时血清总胆固醇差异无统计学意义。从中年到晚年，血清TC中度降低（0.5至2 mmol/L）与晚年认知状态受损风险显著相关，即使在调整了年龄、随访时间、性别、正规教育年限、中年胆固醇、体重指数变化、APOE β 4基因型、心肌梗死/卒中/糖尿病史和降脂治疗后。结论：血清总胆固醇（TC）与痴呆的关系似乎是双向的。高中年血清TC是随后痴呆/阿尔茨海默病的风险因素，但中年后血清TC降低可能反映了正在进行的疾病过程，并可能代表晚年认知障碍的风险标志物。
Background: Longitudinal studies have shown that high serum total cholesterol (TC) at midlife is a risk factor for dementia/Alzheimer disease. The significance of TC later in life is unclear. Objective: To investigate changes in serum TC from midlife to late life and their relationship with late-life cognition. Methods: Participants of the Cardiovascular Risk Factors, Aging and Dementia study were derived from random, population-based samples previously studied in a survey in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1,449 individuals aged 65 to 79 were reexamined in 1998. Results: Serum TC levels decreased in most individuals. High midlife TC represented a risk factor for more severe cognitive impairment later in life, and the values were significantly different between the control, mild cognitive impairment, and dementia groups. There were no significant differences in serum TC at reexamination. A moderate decrease in serum TC from midlife to late life (0.5 to 2 mmol/L) was significantly associated with the risk of a more impaired late-life cognitive status, even after adjusting for age, follow-up time, sex, years of formal education, midlife cholesterol, changes in body mass index, APOE epsilon 4 genotype, history of myocardial infarction/stroke/diabetes, and lipid-lowering treatment. Conclusions: The relationship between serum total cholesterol (TC) and dementia seems to be bidirectional. High midlife serum TC is a risk factor for subsequent dementia/Alzheimer disease, but decreasing serum TC after midlife may reflect ongoing disease processes and may represent a risk marker for late-life cognitive impairment.