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Association of plasma high-density lipoprotein cholesterol level with risk of incident dementia: a cohort study of healthy older adults.
Hussain, Sultana Monira; Robb, Catherine; Tonkin, Andrew M; Lacaze, Paul; Chong, Trevor T-J; Beilin, Lawrence J; Yu, Chenglong; Watts, Gerald F; Ryan, Joanne; Ernst, Michael E; Zhou, Zhen; Neumann, Johannes T; McNeil, John J.
Afiliación
  • Hussain SM; School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia.
  • Robb C; Department of Medical Education, Melbourne Medical School, The University of Melbourne, Victoria, 3010, Australia.
  • Tonkin AM; School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia.
  • Lacaze P; School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia.
  • Chong TT; School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia.
  • Beilin LJ; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, 3800, Australia.
  • Yu C; Department of Neurology, Alfred Health, Melbourne, VIC, 3181, Australia.
  • Watts GF; Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, VIC, 3065, Australia.
  • Ryan J; School of Medicine, University of Western Australia, Perth, Australia.
  • Ernst ME; School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia.
  • Zhou Z; School of Medicine, University of Western Australia, Perth, Australia.
  • Neumann JT; School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia.
  • McNeil JJ; Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, IA, USA.
Lancet Reg Health West Pac ; 43: 100963, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38456089
ABSTRACT

Background:

Recent studies have reported associations between high plasma high-density lipoprotein cholesterol (HDL-C) levels and risk of all-cause mortality, age-related macular degeneration, sepsis and fractures, but associations with dementia risk remain unclear. To determine whether high plasma HDL-C levels are associated with increased incident dementia risk in initially-healthy older people.

Methods:

We conducted a post-hoc analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial; a double-blind, randomized, placebo-controlled trial of daily low-dose aspirin in healthy older people. ASPREE recruited 16,703 participants aged ≥70 years (from Australia) and 2411 participants aged ≥65 years (from the US) between 2010 and 2014. Participants had no diagnosed cardiovascular disease, dementia, physical disability, or life-threatening illness at enrolment and were cognitively healthy (3MS score ≥78). All-cause dementia was a primary trial endpoint, and determined by DSM-IV criteria. Cox regression was used to examine hazard ratios between HDL-C categories <40 mg/dL, 40-60 mg/dL (reference category), 60-80 mg/dL, and >80 mg/dL and dementia. Restricted cubic spline curves were used to determine nonlinear associations. Data analysis was performed from October 2022 to January 2023.

Findings:

Of the 18,668 participants, 850 (4.6%) cases of incident dementia were recorded over 6.3 (SD 1.8) years. Participants with high HDL-C (>80 mg/dL) had a 27% higher risk of dementia (HR 1.27, 95% CI 1.03, 1.58). Age stratified analyses demonstrated that the risk of incident dementia was higher in participants ≥75 years compared to participants <75 years (HR 1.42, 95% CI 1.10, 1.83 vs HR 1.02, 95% CI 0.68, 1.51). Associations remained significant after adjusting for covariates including age, sex, country of enrolment, daily exercise, education, alcohol consumption, weight change over time, non-HDL-C, HDL-C-PRS, and APOE genotype.

Interpretation:

In a population of initially-healthy older adults aged ≥75 years, high HDL-C levels were associated with increased risk of all-cause dementia.

Funding:

National Institutes of Health, USA; National Health and Medical Research Council Australia; Monash University (Melbourne, VIC, Australia); and the Victorian Cancer Agency (Australia).
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 6_ODS3_enfermedades_notrasmisibles Problema de salud: 6_alzheimer_other_dementias / 6_mental_health_behavioral_disorders Idioma: En Revista: Lancet Reg Health West Pac Año: 2024 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 6_ODS3_enfermedades_notrasmisibles Problema de salud: 6_alzheimer_other_dementias / 6_mental_health_behavioral_disorders Idioma: En Revista: Lancet Reg Health West Pac Año: 2024 Tipo del documento: Article País de afiliación: Australia
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