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Christiane Reitz, MD; Ming-Xin Tang, PhD; Jose Luchsinger, MD; Richard Mayeux, MD

Arch Neurol. 2004;61:705-714.

Background  The relation between plasma lipid levels and Alzheimer disease (AD) and vascular dementia (VaD), and the impact of drugs to lower lipid levels remains unclear.

Objective  To investigate the relation between plasma lipid levels and the risk of AD and VaD and the impact of drugs to lower lipid levels on this relationship.

Design and Setting  Cross-sectional and prospective community-based cohort studies.

Participants  Random sample of 4316 Medicare recipients, 65 years and older, residing in northern Manhattan, NY.

Main Outcome Measures  Vascular dementia and AD according to standard criteria.

Results  Elevated levels of non–high-density lipoprotein (HDL-C) and low-density lipoprotein cholesterol (LDL-C) and decreased levels of HDL-C were weak risk factors for VaD in either cross-sectional or prospective analyses. Higher levels of total cholesterol were associated with a decreased risk of incident AD after adjustment for demographics, apolipoprotein E genotype, and cardiovascular risk factors. Treatment with drugs to lower lipid levels did not change the disease risk of either disorder.

Conclusions  We found a weak relation between non–HDL-C, LDL-C, and HDL-C levels and the risk of VaD. Lipid levels and the use of agents to lower them do not seem to be associated with the risk of AD.

From the Gertrude H. Sergievsky Center (Drs Reitz, Tang, Luchsinger, and Mayeux), the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Drs Luchsinger and Mayeux), the Departments of Medicine (Dr Luchsinger), Neurology (Dr Mayeux), and Psychiatry (Dr Mayeux), and the Departments of Biostatistics (Dr Tang) and Epidemiology (Dr Mayeux) in the Mailman School of Public Health, Columbia University College of Physicians and Surgeons, New York, NY.

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