title: The role of extracerebral cholesterol homeostasis and ApoE e4 in cognitive decline.
abstract: We examined the associations between extracerebral markers of cholesterol homeostasis and cognitive decline over 6 years of follow-up, and studied the modifying effect of apolipoprotein E (ApoE) e4. Data were collected in the Longitudinal Aging Study Amsterdam (n = 967, with longitudinal data on cognition, ages ≥ 65 years) and analyzed using linear mixed models. General cognition (Mini-Mental State Examination; MMSE), memory (Auditory Verbal Learning Test), and information processing speed (Coding task) were measured. The results show that ApoE e4 was a significant effect modifier. Significant associations were found only in ApoE e4 noncarriers (n = 718). We found a nonlinear negative association between the ratio of lanosterol to cholesterol (≤ 189.96 ng/mg), a marker for cholesterol synthesis, and general cognition. Lower cholesterol absorption, i.e., lower ratios of campesterol and sitosterol to cholesterol, as well as a higher rate of cholesterol synthesis relative to absorption were associated with lower information processing speed. In ApoE e4 carriers, the negative association between the ratio of campesterol to cholesterol and memory reached borderline significance. Future research should focus on the interaction between (disturbed) cholesterol homeostasis and ApoE e4 status with respect to dementia.
authors.affiliation: Longitudinal Aging Study Amsterdam and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. tn.vandenkommer@vumc.nl
authors.forename: Tessa N
authors.initials: TN
authors.lastname: van den Kommer
authors.forename: Miranda G
authors.initials: MG
authors.lastname: Dik
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
authors.forename: Dieter
authors.initials: D
authors.lastname: Lütjohann
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
authors.forename: Cees
authors.initials: C
authors.lastname: Jonker
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000096:biosynthesis / Q000235:genetics / Q000502:physiology*; D001923:Brain Chemistry / Q000235:genetics; D002784:Cholesterol / Q000031:analogs & derivatives / Q000235:genetics / Q000502:physiology*; D003072:Cognition Disorders / Q000235:genetics / Q000378:metabolism*; D015536:Down-Regulation / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006580:Genetic Carrier Screening; D006706:Homeostasis / Q000235:genetics*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010840:Phytosterols / Q000235:genetics / Q000502:physiology
chemical_list: D053327:Apolipoprotein E4; D010840:Phytosterols; C021273:campesterol; D002784:Cholesterol