Midlife high cholesterol linked to late-life dementia

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If you have high cholesterol while in your 40s — more is at risk than just your heart. Research shows that your mind is also at risk.

Kaiser Permanente studied people with mid to high cholesterol levels for 40 years. The results showed a sobering connection: a higher incidence of Alzheimer’s Disease and vascular dementia.

High cholesterol, labeled as 240 or higher by doctors, increases the risk of Alzheimer’s disease by 66 percent compared to regular cholesterol levels. People with borderline levels — 200 to 239 million per deciliter of blood — also have a higher risk, about 52 percent more.

Vascular dementia, the second most common form of dementia after Alzheimer’s disease, is a group of dementia syndromes caused by conditions affecting the blood supply to the brain. Scientists are still trying to pinpoint the genetic factors and lifestyle causes for Alzheimer’s disease.

The study measured cholesterol levels for nearly a decade, when the test subjects were 40 to 45 years old, then followed them for 40 years. It is the largest long-term study with the most diverse population to examine the relationship between midlife cholesterol levels and late life dementia.

“Our study shows that even moderately high cholesterol levels in your 40s puts people at greater risk for Alzheimer’s disease and vascular dementia decades later,” said Rachel Whitmer, the study’s senior author. “Considering that nearly 100 million Americans have either high or borderline cholesterol levels, this is a disturbing finding. The good news here is that what is good for the heart is also good for the mind, and this is an early risk factor for dementia that can be modified and managed by lowering cholesterol through healthy lifestyle changes.”

The study, paid for by the National Institutes of Health, adds to other research emphasizing the importance of addressing dementia risk factors in midlife, before an underlying disease or symptoms appear, the researchers said.

“Our findings add to the existing body of evidence on a degree of overlap between two dementia types in terms of risk factors, symptoms and neuropathology,” said Alina Solomon, a researcher with the Department of Neurology at the University of Kuopio, Finland. “Dementia and cardiovascular disease are common major health problems, share several risk factors and often occur simultaneously, interacting with one another. A holistic approach that addresses multiple major health problems simultaneously is needed to effectively manage these disorders.”

The study tracked members of Kaiser Permanente’s Northern California Medical Group from 1967 to 2007 by using the multiphasic testing records pioneered by Kaiser Permanente founding physician Morris Collen.

Of the original 9,844 participants, 598 were diagnosed with Alzheimer’s disease or vascular dementia between 1994 and 2007, when the participants were between 61 and 88 years old.

The study did not examine the mechanism of the link between cholesterol levels and dementia.

Medicaid rolls increase

As the economy continues to falter, more people are signing up for Medicaid. Nearly 10 percent of Colorado’s population is now enrolled in the program.

The pace has set records in the state — and El Paso County has seen a similar jump. The county had 56,008 people enrolled as of June 30, compared to 47,946 for the same period last year.

Statewide, 467,556 people are on the books, 79,488 more than during 2008.

The year-over-year average increase in enrollment was 14 percent, exceeding the highest average yearly enrollment spike of 12.3 percent during 2002-03, the last recession.

The increase on the rolls comes as the state is faced with budget problems. Colorado had to make up for a $1.4 billion shortfall and now faces another deficit of nearly $1 billion for the next two years.

Federal stimulus money is helping meet demand. Colorado’s share has dropped to 38.4 percent, while the federal government pays for 61.59 percent.

The state has cut the rate of payments to doctors, hospitals and other health care providers in order to make ends meet.

New partnerships

Personalized medicine, which targets treatments based on people’s individual genes, proteins and environments to prevent and treat disease, is expected to increase alliances between the companies that provide diagnostics and pharmaceutical companies.

The information comes in a PricewaterhouseCoopers report, “Diagnostics 2009: Moving toward personalized medicine.”

“We expect alliances with the pharmaceutical industry to increase in the next two-to-five years, but this will be driven by factors including the pricing of diagnostics, the extent of reimbursement coverage and the burden of any clinical validation work required for market access,” said Gerald McDougall, principal in the health sciences practice at PricewaterhouseCoopers.

The report highlights the prominence of personalized medicine in current merger and acquisition and licensing deal activity in the in vitro diagnostics sector.

Amy Gillentine covers health care for the Colorado Springs Business Journal.

2 Responses to Midlife high cholesterol linked to late-life dementia

  1. ..but countless studies show that lower cholesterol is associated with higher overall mortality.
    In other words, those with higher cholesterol live longer.

    This research is obviously funded by the drug companies who love to make us think statin drugs are good for us.

    August 7, 2009 at 3:16 pm

  2. Here is another way at looking at the pathway between emotions and cholesterol which can be the precursor of more serious conditions like Alzheimers.-
    Traditional Chinese Medicine (TCM) and the heart.
    In TCM it is said the ‘heart houses the mind’. The heart is considered the main organ governing mental activities and its links to the brain. Put another way, there is a mutual effect and correlation between the heart dominating the vessels and the vessels supplying the mind.

    To give an example of how emotional stress can have a physiological effect, here is an extract from an article published in the Daily Mail in March 2006 entitled ‘ Row with your loved one hurts the heart’ where it was reported that a three year study of older married couples found their arteries hardened and narrowed after they were involved in arguments, raising their risk of heart disease.
    For women, this happened when the row took on a hostile nature. But for men it occurred only when either they or their wife acted in a dominating and controlling manner. American scientists asked 150 couples in their 60s and 70s to discuss a sore topic such as money or their in-laws for six minutes. Each conversation was observed by psychologists who gave a point score for friendly, hostile or dominant behaviour. Two days later the couples were given CAT scans to show the extent of atherosclerosis. The results revealed that the couples who had the most stormy rows showed the most signs of having narrowed arteries.
    Tim Smith, Professor of Psychology at the University of Utah, said, ‘Disagreements are an unavoidable fact of relationships, but the way we talk during disagreements gives us an opportunity to do something healthy. If you were concerned about men’s heart health, you would ask couples to find ways to talk about disagreements without trying to control each other. If you were concerned about women’s heart health, you would encourage couples to find ways to have disagreements that were not hostile.’

    Stephen Guy-Clarke
    August 14, 2009 at 4:12 am