Serum cholesterol levels within the high normal range are associated with better cognitive performance among Chinese elderly

Lv, Yue; Yin, Zhaoxue; Chei, Choy Lye; Brasher, Melanie Sereny; Zhang, J.; Kraus, Virginia B.; Qian, Frank; Shi, Xiaoming; Matchar, David B.; Zeng, Yi

doi:10.1007/s12603-016-0701-6

Cited by 65 publications

(53 citation statements)

References 57 publications

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“…On the other hand, dyslipidemia was found to be a protective factor in the present study, which means that the participants who were diagnosed with dyslipidemia had a decreased risk of cognitive decline after stroke. This finding is similar to those of other large studies of older people that reported an association of high triglyceride [44]and LDL levels with better cognitive performance [45].In contrast, a longitudinal study of 1,159 elderly Chinese individuals found associations between the elevated levels of total cholesterol and LDL-accelerated cognitive decline [46]. To elucidate current findings, it may be explained that statin use was associated with a reduced risk of dementia in participants without MCI at the baseline [47].The pleiotropic effects of statin might favorably affect cognitive function through pro-endothelial activity, stabilization of atherosclerotic plaques, antiinflammation, and inhibition of thrombogenesis.…”

Section: Discussionsupporting

confidence: 92%

Association between Stroke and Cognitive Decline in Community Dwelling Older and Oldest People: The SONIC Study

Srithum¹,

Kabayama²,

Gondo³

et al. 2019

Preprint

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Background Increasing in the older people and a decline in mortality after stroke, the rate of poststroke cognitive decline has increased. The relationship between risk factors and post-stroke cognitive decline in dwelling old and oldest people who living in the community especially with asymptomatic stroke have to be elucidated. Therefore, the aim of this study is to investigate the association between stroke and cognitive decline during three years in community dwelling older and oldest people. Methods This study was longitudinal study with a 3-year follow-up in urban and rural areas of Japan. The participants were 1,333 community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, and long-term care (LTC) service used). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was used for cognitive assessment, and a decline of ≥ 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up.Results Rates of cognitive decline increased in advanced ages, equaling 33.3, 39.4, and 66.7% in those aged 70, 80, and 90 years old, respectively. The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3year follow-up. ConclusionsThe cognitive decline after the 3-year follow-up was influenced by the history of stroke, advanced age, and greater MoCA-J score at the baseline, but protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people. 4

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Section: Discussionsupporting

confidence: 92%

Association between Stroke and Cognitive Decline in Community Dwelling Older and Oldest People: The SONIC Study

Srithum¹,

Kabayama²,

Gondo³

et al. 2019

Preprint

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“…31 This study demonstrated that a higher concentration of TG was associated with better functional performance and lower risk of decline in functional performance. Our current findings are consistent with our previous studies 11,32 ; they are also supported by accumulating evidence 33,34 that the association between evaluated TG and cognitive impairment might not hold or even be inverted for the oldest old. Lower TGs were negatively associated with ADL performance in women aged 95 years and older 35 and predicted severe disability and higher all-cause mortality in patients with acute ischemic stroke 36 ; additionally, TG has been shown to be a serological marker of frailty.…”

Section: Association Of Tg With Functional Performancesupporting

confidence: 93%

Triglycerides Paradox Among the Oldest Old: “The Lower the Better?”

Chen

Gao

et al. 2019

J American Geriatrics Society

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OBJECTIVES Currently, most treatment guidelines suggest lowering hypertriglyceridemia of any severity, even in elderly individuals. However associations of serum triglycerides (TGs) with adverse health and mortality risk decrease with age, it remains unclear among the oldest old (aged 80 years and older). The study was to investigate the relationship of serum TG concentrations with cognitive function, activities of daily living (ADLs), frailty, and mortality among the oldest old in a prospective cohort study. DESIGN Longitudinal prospective cohort study. SETTING Community‐based setting in longevity areas in China. PARTICIPANTS A total of 930 (mean age = 94.0 years) Chinese oldest old. MEASUREMENTS The TG concentrations were measured at baseline survey in 2009. Cognitive function, ADLs, frailty, and mortality were determined over 5 years of follow‐up. Cox proportional hazards models and competing risk models were performed to explore the association, adjusting for potential confounders. RESULTS Each 1‐mmol/L increase in TGs was associated with a nearly 20% lower risk of cognitive decline, ADL decline, and frailty aggravation during the 5 years of follow‐up. Consistently, higher TGs (each 1 mmol/L) was associated with lower 5‐year all‐cause mortality after fully adjustment (hazard ratio [HR] = 0.79; 95% confidence interval [CI] = 0.69‐0.89). Nonelevated TG concentrations (less than 2.26 mmol/L) were associated with higher mortality risk (HR = 1.72; 95% CI = 1.22‐2.44), relative to TGs of 2.26 mmol/L or more. We observed similar results regarding TG concentrations and mortality in 1‐year lag analysis and when excluding participants with identified chronic disease. CONCLUSION In the oldest old, a higher concentration of TGs was associated with a lower risk of cognitive decline, ADL decline, frailty aggravation, and mortality. This paradox suggests the clinical importance of revisiting the concept of “the lower the better” for the oldest old. J Am Geriatr Soc 67:741–748, 2019.

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“…There is no exploring the directly relationship between serum lipids and cognitive function in different BMI levels. Yuebin Lv, et al (15) found that TG was associated with MMSE score, but after adjustment for central obesity and other confounding factors, it was not associated with the risk of cognitive impairment. Of the similar studies which have examined whole samples without BMI strati cation, some cross-sectional and prospective studies found inconsistent associations with serum TG ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Two studies reported that lower TG was associated with higher cognitive scores in most cognitive domains (13) and better short-term memory (14). Yuebin Lv, et al (15) found that TG was associated with Mini Mental Status Examination (MMSE) score, but after adjustment for central obesity and other confounding factors, it was not associated with the risk of cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

Subgroup analysis of the influence of body mass index on the association between serum lipids and cognitive function in Chinese population

Cao

Xiao

2020

Preprint

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Background: Previous studies reported that the association between lipid levels and cognitive function related with gender, age and specific cognitive domains, but the influence of body mass index (BMI) on this association is limited. This triggered our interest in exploring how serum lipids relate to cognitive function in different subgroups. Methods: Data was collected from 2009 wave and 2015 wave of China Health and Nutrition Survey (CHNS). Multivariable linear regression analyses examined serum lipids level as predictors of sex- and age-specific measure of cognitive function in different BMI levels, which were adjusted for nationality, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), smoking status, alcohol consumption and education level. Results: Cognitive function score have different concentration curves in serum lipids quartile levels in different BMI categories. After adjustment for confounding factors, serum TG was positively associated with cognitive function score in underweight (β±SE: 2.06±0.88, P=0.023) and obese (β±SE: 1.44±0.71, P=0.045) male group, and serum HDL-C was positively associated with cognitive function score in overweight (β±SE: 1.89±0.92, P=0.041) and obese (β±SE: 5.04±1.62, P=0.002) female group. Serum TC was negatively associated with cognitive function score in overweight (β±SE: -2.55±1.26, P=0.043) mid-life adults, and serum HDL-C was positively associated with cognitive function score in overweight (β±SE: 2.15±0.94, P=0.022) and obese (β±SE: 5.33±2.07, P=0.011) older adults. Conclusion: The associations of serum lipids with cognitive function were related with BMI levels and differed between gender and age groups. This result indicated that better nutritional status has superior cognitive function performance.

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Serum cholesterol levels within the high normal range are associated with better cognitive performance among Chinese elderly

Cited by 65 publications

References 57 publications

Association between Stroke and Cognitive Decline in Community Dwelling Older and Oldest People: The SONIC Study

Association between Stroke and Cognitive Decline in Community Dwelling Older and Oldest People: The SONIC Study

Triglycerides Paradox Among the Oldest Old: “The Lower the Better?”

Subgroup analysis of the influence of body mass index on the association between serum lipids and cognitive function in Chinese population

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