Higher Total Cholesterol Concentration May Be Associated with Better Cognitive Performance among Elderly Females

Abstract

Background: The brain contains the highest level of cholesterol in the body, and the total amount of serum cholesterol in the blood has a huge impact on brain aging and cognitive performance. However, the association of total serum cholesterol with cognitive function remains uncertain. This study determines whether there is an association between the total amount of cholesterol in the blood and cognitive performance in elderly females without a history of stroke. Methods: This population-based cross-sectional study was conducted on elderly (over 60 years old) females and males without a history of stroke from 2011 to 2014 in the US National Health and Nutrition Examination Survey (NHANES). The primary exposure was total blood cholesterol, and the main outcome was cognitive performance; this association was assessed with logistic regression analysis and restricted cubic splines. Results: 1309 female and 1272 male participants were included. In females, higher total cholesterol was significantly associated with higher cognitive scores, particularly in the digit symbol substitution test (OR 0.51, 95% CI (0.36–0.72)) and the animal fluency test (OR 0.64, 95% CI (0.45–0.91)). This association remained significant in models adjusted for age, race, smoking status, education level, and chronic conditions (OR 0.40, 95% CI (0.25–0.63)). This association was not significant in males, however. Conclusions: A higher concentration of total cholesterol measured in later life may be a protective factor for cognitive performance among females over 60 years old without a history of stroke. Further, this association was more pronounced among women with higher levels of education than women with lower or no education.

Associations between lipid profiles and late‐life cognitive impairment among oldest‐old and centenarian adults

“…To date, evidences for the association between TC levels and cognitive function were conflicting. Some studies reported that TC levels were negatively, positively, or not associated with cognitive impairment 14–16,19,20,23,24 . Our results on the association between TC and cognition were consistent with several studies.…”

“…Our results on the association between TC and cognition were consistent with several studies. A more recent study suggested that higher TC levels were statistically associated with improved cognitive function among females over 60 years old 14 . Research based on a representative sample of participants aged 70 years and older revealed that both lower TC levels and decreased TC levels were related to relatively poorer cognition 15 .…”

“…Some studies reported inverse associations between serum lipids and late‐life cognitive impairment, whereas other studies showed positive associations or no association. Pang et al 14 . and Thorvaldsson et al 15 .…”

“…Some studies reported inverse associations between serum lipids and late-life cognitive impairment, whereas other studies showed positive associations or no association. Pang et al 14 and Thorvaldsson et al 15 reported that lower TC levels were associated with relatively poorer cognition among individuals over 60 years. Ma et al 16 found that TC and LDL-C were risk factors for cognitive function.…”

Examination of brain area volumes based on voxel-based morphometry and multidomain cognitive impairment in asymptomatic unilateral carotid artery stenosis

“…In contrast, a meta-analysis showed that there was no clear consistent relationship between cholesterol and cognitive decline ( Peters et al, 2021 ). Furthermore, some studies have demonstrated that a higher concentration of TC might be a protective factor for cognitive performance ( Lv et al, 2016 ; Pang et al, 2022 ). Therefore, further experiments are needed to identify the correlation between serum TC and cognitive impairment.…”