Longitudinal and nonlinear relations of dietary and Serum cholesterol in midlife with cognitive decline: results from EMCOA study
An Y, Zhang X, Wang Y, Wang Y, Liu W, Wang T, Qin Z, Xiao R
Molecular neurodegeneration · 61 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Health markers and function
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Government
- National Natural Science Foundation of China
- University or hospital
- Capital Medical University
- Grants
- National Natural Science Foundation of China (Grant No. 81673149); National Natural Science Foundation of China (81330065); National Natural Science Foundation of China (No. 81673149); National Natural Science Foundation of China (81673149)
Based on 2 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2019-12-01 · Mol Neurodegener · vol. 14 · issue 1 · p. 51
- Publisher
- BioMed Central
- Cited
- 82 citations · more than 97% of similar papers · 6.0× the field average
- Impact
- Top 10% most cited in its field
- References
- 50 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Nutritional Studies and Diet · Cholesterol and Lipid Metabolism · Alzheimer's disease research and treatments
- Keywords
- Cognitive decline, Cognition, Gerontology, Longitudinal study, Medicine, Neurology, Cholesterol, Internal medicine, Psychology, Physiology, Clinical psychology, Dementia, Psychiatry, Pathology, Disease
- MeSH
- humans, cholesterol, triglycerides, risk factors, cognition, memory, aged, middle aged, female, male, cholesterol, ldl, cholesterol, hdl, cognitive dysfunction
8 authors
From CN
- Yu AnCapital Medical University
- Xiaona ZhangCapital Medical University
- Ying WangCapital Medical University
- Yushan WangCapital Medical University
- Wen LiuCapital Medical University
- Tao WangCapital Medical University
Abstract
Background
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.
Methods
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.
Results
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 < 0.05). In mixed effect linear models, quadratic and longitudinal relations of dietary cholesterol and egg intakes to global cognition, processing speed and executive function were observed. Moreover, there were inverted U-shaped relations of HDL-C, with processing speed and executive function but U-shaped relations of HDL-C and LDL-C/HDL-C ratio with verbal memory. Adverse linear associations of higher LDL-C and LDL-C/HDL-C ratio with multiple cognitive comes were also revealed. Additionally adjusting for APOE genotype did not modify cholesterol-cognition associations. Dietary and serum cholesterol had variable associations with global and domain-specific cognitive decline across educational groups.
Conclusion
Differential associations between dietary/serum cholesterol and cognitive decline across different domains of function were observed in a particular population of middle-aged and elderly Chinese. Interventions to improve cognitive reserve regarding dietary instruction and lipid management should be tailored according to specific target.
Trial registration
EMCOA, ChiCTR-OOC-17011882, Registered 5th, July 2017-Retrospectively registered, http://www.medresman.org/uc/project/projectedit.aspx?proj=2610.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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