Table 49Total cholesterol and risk of cognitive decline

StudySampleFollowupExposureCase definitionConfounding adjustmentResults
Knopman et al., 2001270

ARIC
Community cohort (10,610)6.0 years (0.3)Hypercholesterolemia, directly measured as LDL ≥ 140 or use of lipid lowering agent; fasting status not specifiedWord fluency
DSST
DWR
Age
Race
Sex
Educational level
Site
CNS-relevant medications
Hyperlipidemia not associated with declines on any test
Packard et al., 2007284

PROSPER
Cohort formed from an RCT (5804)Mean 3.2 years; range, 0.7 to 4.2Directly measured twice at baselineMMSE
Picture-word learning test
Stroop Color and Word Test
Letter digit coding test
Age
Sex
Country
Education
History of vascular disease, MI, stroke, TIA, smoking, antihypertensive medication, BP, BMI, or DM
Triglycerides
Treatment allocation
APOE e4
Baseline cognitive test scores
Differences between last on-treatment and the second of two baseline measures. Difference in changes scores reported (by LDL-C and HDL-C tertile).

No significant difference for any cognitive measure

Activities of daily living and independent activities of daily living: No significant difference by LDL-C or HDL-C tertile for either outcome

Abbreviations: APOE e4 = e 4 allele of the apolipoprotein E gene; ARIC = Atherosclerosis Risk in Communities; BP = blood pressure; BMI = body mass index; CNS = central nervous system; DM = diabetes mellitus; DSST = Digit Symbol Substitution Test; DWR = Delayed Word Recall; HDL = high density lipoprotein; HDL-C = high density lipoprotein cholesterol; LDL = low density lipoprotein; LDL-C = low density lipoprotein cholesterol; MCI = mild cognitive impairment; MI = myocardial infarction; MMSE = Mini-Mental State Examination; PROSPER = Prospective Study of Pravastatin in the Elderly at Risk; SD = standard deviation; TIA = transient ischemic attack; RCT = randomized controlled trial

From: 3, Results

Cover of Preventing Alzheimer's Disease and Cognitive Decline
Preventing Alzheimer's Disease and Cognitive Decline.
Evidence Reports/Technology Assessments, No. 193.
Williams JW, Plassman BL, Burke J, et al.

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