ApoB, small-dense LDL-C, Lp(a), LpPLA ₂ activity, and cognitive change

Abstract

ObjectiveTo examine the association of specific lipoproteins/inflammatory enzyme with cognitive change.MethodsWe examined the association of apolipoprotein B (ApoB), small-dense low-density lipoprotein cholesterol (sdLDL-C), lipoprotein (a) (Lp[a]), and lipoprotein-associated phospholipase A2 (LpPLA2) activity with 15-year change in Delayed Word Recall Test, Digit Symbol Substitution Test (DSST), Word Fluency Test (WFT), and overall summary score in 9,350 participants in the Atherosclerosis Risk in Communities study. We assessed interaction by race, sex, education, APOE ε4 status, and statin use. We also addressed questions of informative missingness, the role of stroke, and the influence of fasting status.ResultsThe mean (SD) age was 63.4 (5.7) years; 56.4% were women and 17.4% were black. We observed faster cognitive decline on DSST and global z scores with every 10-mg/dL higher sdLDL-C level (Δ DSST z score, −0.010; 95% confidence interval [CI] −0.017, −0.002 and Δ global z score, −0.011; −0.021, −0.001) and the highest vs the lowest ApoB quintiles (Δ DSST z score, −0.092; −0.0164, −0.019 and Δ global z score, −0.101; −0.200, −0.002). Association for the ApoB quintiles with Δ global z score (−0.10) was comparable with that of having 1 APOE ε4 allele (−0.11). Higher Lp(a) was associated with slower decline in DSST, WFT, and global z scores. LpPLA2 activity was not associated with cognitive change. Results were similar in sensitivity analyses. The associations of sdLDL-C or Lp(a) on cognitive change were more pronounced in statin users.ConclusionsOptimal control of atherogenic lipoproteins such as ApoB and sdLDL-C in midlife for cardiovascular health may also benefit late-life cognitive health.

Late‐onset epilepsy and 25‐year cognitive change: The Atherosclerosis Risk in Communities (ARIC) study

“…Individual scores were converted to z‐scores using Visit 2 means and standard deviations as referents. We calculated a global measure of cognition for each participant from the individual z‐scores, which was then converted to a global z‐score using Visit 2 mean and standard deviation as referents 19,20,23,24 …”

Vascular mild cognitive impairment and its relationship to hemoglobin A1c levels and apolipoprotein E genotypes in the Dominican Republic

“…Similarly, two other studies observed that for every 10 mg increase in small-dense low-density lipoprotein cholesterol (sdLDL-C), there was an accelerated cognitive deterioration. 46 A high concentration of total cholesterol and LDL-C in late life was associated with a rapid cognitive impairment. On the contrary, another study found that MCI patients had a significant amount of small HDL when compared to the Alzheimer group, 47 higher midlife HDL-C halve the risk of developing MCI and lowered risk of dementia later in life, 48 suggesting an association between HDL subclasses and MCI.…”

Relationship Between Lipoprotein (a) [Lp(a)] and Cognition in Different Ischemic Stroke Subtypes

“…Conversely, a prospective cohort of 2,532 subjects of Finnish ( 15 ) male population in 24.9 years' follow-up, showed that Lp(a) was protective of future dementia risk. Another large prospective cohort study based on four United States communities ( 13 ) showed that higher Lp(a) levels were associated with slower cognitive decline in semantic fluency over 15 years. What is more, negative results were also obtained in several studies.…”

“…However, the relationship between serum Lp(a) and cognitive impairment or dementia is still controversial. Previous studies have shown that Lp(a) had an adverse effect ( 8 , 9 ) or no effect ( 10 – 12 ) on cognition, whereas, in recent years some studies have found that it had a beneficial influence ( 13 – 15 ).…”