Bad cholesterol, vascular risk and dementia

Abstract

The prevalence of dementia and cognitive impairment is increasing globally as lifespan lengthens and presents major health care challenges as well as creating significant social burdens. Although Alzheimer disease is the most common type of dementia, autopsy and neuroimaging studies show that the majority of dementia cases also have cerebral vascular pathology (such as infarcts, white matter lesions and cerebral microbleeds). In keeping with this, many studies and systematic reviews have shown that higher levels of vascular risk factors and cardiovascular disease predict future risk of dementia and cognitive decline. The extent to which modifying vascular risk factors such as blood cholesterol and blood pressure might prevent dementia has become an important question. Using data from 3 large randomised trials of cholesterol modification we have estimated the impact of different types of incident vascular events on cognitive aging to help understand the potential power of randomised studies to detect such effects. These data provide quantitative estimates of the impact of LDL-lowering on cognitive aging and will be presented.