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Cholesterol, Diabetes Linked to Faster Decline in Alzheimer’s Disease

Among patients with incident Alzheimer’s disease, total and LDL cholesterol concentrations before diagnosis and a history of diabetes are associated with faster cognitive decline.¬†Specifically, each 10-mg/dL increase in total cholesterol or LDL-C concentration was associated with an additional …

Among patients with incident Alzheimer’s disease, total and LDL cholesterol concentrations before diagnosis and a history of diabetes are associated with faster cognitive decline.

“Few treatment options are available to improve the prognosis in patients with Alzheimer’s disease (AD),” Dr. Yaakov Stern, of Columbia University Medical Center, New York, and colleagues write. “Controlling vascular conditions may be one way of delaying the disease course,” they note.

“While vascular risk factors have been studied as predictors of AD, few studies have assessed their influence on disease progression,” the researchers note. To investigate, they examined prediagnosis vascular risk in 156 patients with incident AD followed for a mean of 3.5 years. The main outcome measure was the change in a composite score of cognitive ability from diagnosis onward.

A generalized estimating equation model showed an overall decline in composite cognitive score of 0.08 SD per year (p < 0.001).

In models adjusting for age, race/ethnicity, and years of education, associations were observed between higher cholesterol (total and LDL cholesterol) concentrations, a history of diabetes, and faster cognitive decline.

Specifically, each 10-mg/dL increase in total cholesterol or LDL-C concentration was associated with an additional 0.10-SD decrease in cognitive score per year. Diabetes was associated with an additional 0.05-SD decrease in cognitive score per year of follow-up.

“Prevention or treatment of these conditions can potentially slow the course of AD,” Dr. Stern and colleagues conclude.

Arch Neurol 2009;66:343-348.