by Lori Solomon

High levels of HDL cholesterol tied to higher dementia risk

Elevated levels of high-density lipoprotein cholesterol (HDL-C) are associated with an increased risk for all-cause dementia, according to a study published online Nov. 29 in The Lancet Regional Health: Western Pacific.

Sultana Monira Hussain, M.B.B.S., M.P.H., Ph.D., from Monash University in Melbourne, Australia, and colleagues conducted a post-hoc analysis of the Aspirin in Reducing Events in the Elderly trial to determine whether high plasma HDL-C levels are associated with an increased incident dementia risk in initially healthy older people. The analysis included data from 16,703 participants aged 70 years and older from Australia and 2,411 participants aged 65 years and older from the United States.

The researchers found that 4.6 percent of participants developed incident dementia over 6.3 years. Participants with high HDL-C (>80 mg/dL) had a higher risk for dementia (hazard ratio, 1.27; 95 percent confidence interval, 1.03 to 1.58). The risk for incident dementia was higher in participants aged 75 years and older versus participants younger than 75 years in age-stratified analyses (hazard ratio [95 percent confidence interval], 1.42 [1.10 to 1.83] versus 1.02 [0.68 to 1.51]). When adjusting for age, sex, country of enrollment, daily exercise, education, alcohol consumption, weight change over time, non-HDL-C, HDL-C polygenic risk score, and APOE genotype, associations remained significant.

"The increased dementia risk associated with high HDL-C levels appeared to be independent of traditional dementia risk factors, including physical activity level, alcohol intake, education, diabetes, or smoking," the authors write.

Two authors disclosed ties to the pharmaceutical industry.

More information: Sultana Monira Hussain et al, Association of plasma high-density lipoprotein cholesterol level with risk of incident dementia: a cohort study of healthy older adults, The Lancet Regional Health—Western Pacific (2023). DOI: 10.1016/j.lanwpc.2023.100963

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