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Cholesterol's Bad for the Brain, Too

Elevated levels tied to cognitive decline, but drugs may help

THURSDAY, March 14, 2002 (HealthDayNews) -- Evidence that high cholesterol levels are bad for the brain as well as the heart keeps accumulating.

The latest report comes from a long-running study of older women. It says that postmenopausal women with the highest blood readings of low-density lipoprotein (LDL) cholesterol, the "bad kind" that clogs the arteries, did much worse on tests of memory, language, orientation, and other kinds of brain function than women with low cholesterol levels.

That report, published in the March issue of the Archives of Neurology, also adds evidence that statins, the cholesterol-lowering drugs, can reduce the risk of Alzheimer's disease and other brain-robbing conditions.

The case is far from proven, but the clues are strong enough to impel the National Institute on Aging to sponsor a major trial to determine whether statin therapy can help keep old minds young.

The new report uses data from the Heart Estrogen/Progestin Replacement Study Trial, whose primary goal is to see whether hormone replacement therapy can reduce the incidence of heart disease. Women in the study had their cholesterol levels tested periodically and took a test of mental ability at the end of the four-year trial.

Women with the highest LDL cholesterol levels did significantly worse on the tests, says the report by a group led by Dr. Kristine Yaffe, assistant professor of psychology at the University of California, San Diego. But women whose blood cholesterol levels decreased over the four years of the study had better scores than those whose cholesterol levels increased. And taking a statin drug appeared to improve performance on the mental tests.

"These results fit with other studies showing that statins may help to prevent Alzheimer's disease," Yaffe says. The report cites two such studies that were published in November 2000.

"There has always been a debate about whether elevated serum cholesterol is related to cognitive decline," says Bill Thies, vice president for medical and scientific affairs of the Alzheimer's Association. "This is a solid study, with good methodology, that offers excellent evidence. I suspect it will be the first of a number of studies showing that elevated cholesterol is associated with cognitive decline."

But Yaffe added, "Until we see the results of a randomized clinical trial, people shouldn't be taking statins for that purpose."

The NIA-sponsored statin trial, headquartered at the University of California at San Diego, is just beginning, and results are not expected for several years. It is a randomized trial, in which the incidence of mental decline will be compared in people who take a statin or a placebo, an inactive substance.

What To Do

The American Heart Association recommendations for cardiovascular health are equally applicable to mental function, says Thies. "The rules for healthy living are pretty simple. They are not a guarantee, but they give the best chance of getting good results," he says. "Don't smoke, watch your blood pressure, don't get too big, exercise regularly. Those are as good a set of rules as you can get."

Learn more about cholesterol from the American Heart Association. Meanwhile, the National Institute on Aging can steer you toward information on Alzheimer's and brain function.

SOURCES: Bill Thies, Ph.D, vice president for medical and Scientific Affairs, Alzheimer's Association, Chicago; Kristine Yaffe, M.D., assistant professor of psychology, University of California, San Diego; March 2002 Archives of Neurology
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