title: Updating the Evidence on the Association between Serum Cholesterol and Risk of Late-Life Dementia: Review and Meta-Analysis.
abstract: Cohort studies have reported that midlife high total serum cholesterol (TC) is associated with increased risk of Alzheimer's disease (AD) in late-life but findings have been based on few studies and previous reviews have been limited by a lack of compatible data.
  
  
  
  We synthesized all high quality data from cohort studies reporting on the association between total serum cholesterol measured and late-life cognitive outcomes including Alzheimer's disease (AD), vascular dementia (VaD), any dementia, mild cognitive impairment (MCI), and cognitive decline.
  
  
  
  The literature was searched up to October 2016 using a registered protocol. Thirty-four articles meeting study criteria were identified. Seventeen studies published from 1996 to 2014, including 23,338 participants were included in meta-analyses.
  
  
  
  Relative risk of developing AD for adults with high TC in midlife was 2.14 (95% CI 1.33-3.44) compared with normal cholesterol. Individual studies that could not be pooled also reported high TC in midlife increased the risk of MCI and cognitive decline in late-life. High TC in late-life was not associated with MCI, AD, VaD, any dementia, or cognitive decline. Late-life measured HDL cholesterol and triglycerides were not associated with increased risk of VaD, and HDL was not associated with risk of MCI, AD, or any dementia. There were insufficient data to examine other cholesterol sub-fractions, sex differences, or APOE interactions.
  
  
  
  Significant gaps in the literature regarding TC and late-life dementia remain. Evidence suggests that high midlife TC increases risk of late-life AD, and may correlate with the onset of AD pathology.
authors.affiliation: Dementia Collaborative Research Centre - Early Diagnosis and Prevention, Research School of Population Health, The Australian National University, Australia.|Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia.
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ashby-Mitchell
authors.affiliation: Dementia Collaborative Research Centre - Early Diagnosis and Prevention, Research School of Population Health, The Australian National University, Australia.|Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia.
authors.forename: Ruth
authors.initials: R
authors.lastname: Peters
mesh_terms: D000544:Alzheimer Disease / Q000097:blood* / Q000150:complications; D002784:Cholesterol / Q000097:blood*; D060825:Cognitive Dysfunction / Q000097:blood / Q000209:etiology; D015331:Cohort Studies; D003704:Dementia / Q000097:blood* / Q000150:complications; D006801:Humans; D012307:Risk Factors
chemical_list: D002784:Cholesterol
keywords: Cholesterol; cognitive decline; dementia; lipids; review; risk 
  factors