title: Hypercholesterolemia in elders is associated with slower cognitive decline: a prospective, population-based study (NEDICES).
abstract: BACKGROUND
  Studies investigating the association between hypercholesterolemia in the elderly and cognitive decline report discrepant outcomes. We determined in a prospective population-based cohort (NEDICES) in elders whether hypercholesterolemia was associated with slower cognitive decline.
  
  
  METHODS
  Participants were evaluated at baseline and 3 years later. Baseline demographic variables were recorded. Hypercholesterolemia was defined by total cholesterol of >200mg/dl or current use of lipid-lowering drugs. At baseline and at follow-up, a 37-item version of the Mini-Mental State Examination (37-MMSE) was administered.
  
  
  RESULTS
  The final sample, 2015 participants (72.9 ± 6.1 years), comprised 1166 (57.9%) hypercholesterolemic and 849 (42.1%) non-hypercholesterolemic participants (reference category). The mean follow-up was 3.4 ± 0.5 years. During the three year follow-up period, the 37-MMSE declined by 0.7 ± 4.3 points (median=0 point) in non-hypercholesterolemic participants vs. 0.3 ± 3.9 points in hypercholesterolemic participants (median=0 points) (Mann-Whitney test, p=0.007). In analyses adjusted for baseline age and other potential confounders, this difference remained robust. We also assessed the cognitive decline per unit time (i.e., the rate of cognitive decline). The rate of cognitive decline was 0.2 ± 1.3 (median=0.0) points/year for non-hypercholesterolemic participants and 0.1 ± 1.2 (median=0.0) points/year for hypercholesterolemic participants (Mann-Whitney test, p=0.028).
  
  
  CONCLUSIONS
  In this prospective population-based cohort study, cognitive test scores among hypercholesterolemic elders declined more slowly than observed in their non-hypercholesterolemic counterparts. Additional studies are needed to confirm these results.
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain. Electronic address: jbenitol67@gmail.com.
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
authors.affiliation: Arévalo Health Center, Arévalo, Ávila, Spain.
authors.forename: Saturio
authors.initials: S
authors.lastname: Vega-Quiroga
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo-Galende
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: Bermejo-Pareja
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies
keywords: Cognitive function; Elderly; Epidemiology; Hypercholesterolemia; Population-based study