Longitudinal and nonlinear relations of dietary and Serum cholesterol in midlife with cognitive decline: results from EMCOA study

• Published in: Molecular neurodegeneration 2019-12, Vol.14 (1), p.51-51, Article 51
• Main Authors: An, Yu, Zhang, Xiaona, Wang, Ying, Wang, Yushan, Liu, Wen, Wang, Tao, Qin, Zhongsheng, Xiao, Rong
• Format: Article
• Language: English
• Subjects: Alzheimer's disease; Analysis; Apolipoprotein E; Apolipoproteins; Blood; Blood cholesterol; Cardiovascular disease; Cholesterol; Cholesterol tests; Cognition; Cognition & reasoning; Cognitive ability; Cognitive decline; Dementia; Deoxyribonucleic acid; Diabetes; DNA; Education; Eggs; Energy; Executive function; Family medical history; Fasting; Fatty acids; Food; Genetic testing; Genotypes; Geriatrics; High density lipoprotein; Hypertension; Low density lipoprotein; Low density lipoproteins; Memory; Neurodegenerative diseases; Nonlinear; Sociodemographics; Studies; Triglycerides; Variables; Variance analysis
• ISSN: 1750-1326; 1750-1326
• DOI: 10.1186/s13024-019-0353-1

Previous studies regarding the cholesterol-cognition relationship in midlife have generated conflicting results. We thus investigated whether dietary and blood cholesterol were associated with cognitive decline. Participants were drawn from a large cohort study entitled the Effects and Mechanism Investigation of Cholesterol and Oxysterol on Alzheimer's disease (EMCOA) study. We included 2514 participants who completed a selection of comprehensive cognitive tests and were followed for an average of 2.3 years. Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were assessed and dietary intakes were investigated by food frequency questionnaire (FFQ) at baseline. Apolipoprotein E (APOE) was genotyped by Kompetitive Allele Specific PCR (KASP) sequencing. Non-high-density lipoprotein cholesterol (Non-HDL-C) and LDL-C/HDL-C ratio were calculated. The longitudinal effects of dietary and blood cholesterol on risk of global cognitive decline (decrease in Montreal Cognitive Assessment (MoCA) > 2 points) were examined using Cox proportional hazards models. The nonlinear associations with global and domain-specific cognitive decline was evaluated with mixed effect linear models. In Cox proportional hazards models, neither cholesterol nor egg intake was associated with a higher risk of accelerated global cognitive decline. In contrast, the higher serum concentrations of TC, LDL-C, non-HDL-C and LDL-C/HDL-C ratio were positively associated with accelerated global cognitive decline regardless of being evaluated continuously or categorically while higher HDL-C was positively associated with accelerated global cognitive decline only when being evaluated categorically (all P