Gender-specific associations between lipids and cognitive decline in the elderly.
The aim of this study was to examine the associations between serum lipid levels and cognitive function in a community-based sample of non-demented subjects aged 65 years and over. Participants were 2737 men and 4118 women from a population-based cohort recruited from three French cities. Visual memory, verbal fluency, psychomotor speed, and executive abilities were evaluated at baseline, and after 2, 4, and 7 years of follow-up. Lipid levels were evaluated at baseline. Multiadjusted Cox models stratified by gender were adjusted for sociodemographic and lifestyle characteristics, mental and physical health, and genetic vulnerability to dyslipidemia (apolipoprotein E and A, and cholesteryl ester transfer protein) and taking into account baseline vascular pathologies. In men, a hypercholesterolemic pattern in late-life (high total cholesterol (T-C), low HDL-C, high LDL-C levels) was associated with a 25 to 50% increased risk of decline over 7 years in psychomotor speed, executive abilities, and verbal fluency. Specific associations with low T-C and low LDL-C levels were also observed which may depend on genetic vulnerability to dyslipidemia (related to apolipoprotein A5 and cholesteryl exchange transfer protein). In contrast, in women, a 30% higher rate of decline was found in psychomotor speed with high HDL-C levels and in executive abilities with low levels of LDL-C and triglycerides, in interaction with hormonal treatment. For men and women, vascular pathologies only slightly outweighed the risk related to lipids. This suggests a complex gender-specific pattern of cognitive decline involving genetic vulnerability in men and hormonal status in women.
Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France. Electronic address: marie-laure.ancelin@inserm.fr.
Marie-Laure
ML
Ancelin
Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France.
Emmanuelle
E
Ripoche
Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France; CHRU Montpellier, Hop Lapeyronie, Laboratoire de Biochimie, Montpellier, France.
Anne-Marie
AM
Dupuy
Univ Bordeaux, ISPED, U897-Epidemiologie-Biostatistique, Bordeaux, France; Insem, U897, Bordeaux, France.
Cécilia
C
Samieri
CHRU Dijon, Centre Mémoire Ressources et Recherche, Dijon, France.
Olivier
O
Rouaud
Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France.
Claudine
C
Berr
Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France.
Isabelle
I
Carrière
Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France; Faculty of Medicine, Imperial College, London, UK.
Karen
K
Ritchie
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000097:blood* / Q000175:diagnosis; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D011930:Reaction Time / Q000502:physiology; D012737:Sex Factors
D008055:Lipids
Apolipoprotein A; Cholesteryl exchange transfer protein; Cognitive aging; Lipids; Prospective cohort