title: Cholesterol level, statin use and Alzheimer's disease in adults with Down syndrome.
abstract: Adults with Down syndrome (DS) are at significantly higher risk of Alzheimer's disease (AD) than the general population, but there is considerable variability in age at onset. This study tested the hypothesis that total cholesterol (TC) levels are related to vulnerability, and that the use of statins may decrease risk. The relation of TC level and statin use to risk of AD was investigated in 123 Caucasian adults with DS. Evaluations included serial assessments of cognitive, adaptive and maladaptive behavior, medical records, and neurological examinations. Mean length of follow-up was 5.5 years [1.2-7.1] for the entire sample, 5.1 years [1.2-7.1] for subjects who developed dementia, and 5.6 years [1.5-7.1] for those who did not develop dementia. Controlling for covariates, participants with TC>or=200mg/dL were more than two times as likely to develop AD than subjects with lower TC [hazard rate (HR)=2.59, p=.029, 95% CI: 1.1, 6.1]. In contrast, participants with higher TC levels who used statins during the study, had less than half the risk of developing AD than participants with higher TC levels who did not use statins (HR=.402, p=.095, 95% CI: .138, 1.173). If the protective effects of statins can be further validated, these findings suggest that their use may delay or prevent AD onset in vulnerable populations.
authors.affiliation: Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States. wbzigman@aol.com
authors.forename: Warren B
authors.initials: WB
authors.lastname: Zigman
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.forename: Edmund C
authors.initials: EC
authors.lastname: Jenkins
authors.forename: Tiina K
authors.initials: TK
authors.lastname: Urv
authors.forename: Benjamin
authors.initials: B
authors.lastname: Tycko
authors.forename: Wayne
authors.initials: W
authors.lastname: Silverman
mesh_terms: D000328:Adult; D000544:Alzheimer Disease / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D002784:Cholesterol / Q000378:metabolism*; D004314:Down Syndrome / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol