The connection between cardiovascular factors and the brain health It has been closely followed by scientists for decades. What we do from the age of 40 will be reflected when we are 60 or older, so pay attention to cholesterol levelswhich is often underestimated, is key to preventing heart disease and also reducing cognitive decline.
And study presented in the American Heart Association (AHA) Scientific Sessions 2024in Chicago, noted that the significant fluctuations in cholesterol levels over the years they could be related to increased risk of developing dementia or cognitive impairment in older adults.
Previous research had already associated variation in indicators such as blood pressure or blood sugar with a negative impact on the heart and brain. Now, the study published in the journal Circulation He added changes in cholesterol to that list.
A possible explanation is that These variations could destabilize atherosclerotic plaqueswhich increases the risk of cerebral ischemia and, therefore, cognitive deterioration, according to the doctor. Zhen Zhou, lead author of the study and researcher at the Monash University, Australia,
This destabilization of plaque in the arteries can increase the risk of plaque development, rupture and subsequent obstruction of blood flow to the brainsaid the researcher and considered that it is necessary more research “to determine Whether these fluctuations are a risk factor, a precursor or simply a biomarker of risk of dementia.”
“The preliminary study presented at the scientific session of the American Hearth Association showed a significant association between annual fluctuations in cholesterol values and constant medication with the risk of cognitive impairment. People with greater fluctuations increased their risk of dementia by 60%“, he explained to Infobae the doctor Ricardo Allegrihead of Fleni’s Cognitive Neurology, Neuropsychology and Neuropsychiatry.
Meanwhile, the doctor Pablo Corral, former president of the Argentine Lipid Society (SAL)was cautious regarding the findings and stressed that it was an association study and not a causality study, so there may be bias in the results by not taking into account other associated risk factors or data that may affect the link between the variables evaluated.
However, he stressed that “what is good for the heart is good for the brain”, which is why periodic medical control and prevention through healthy lifestyle habits are always important.
Cholesterol is a waxy, fat-like substance that circulates in the blood, produced by the liver and also obtained from foods of animal origin, such as meat, eggs and dairy.
It is measured as total cholesterol and also by its components: low-density lipoprotein, or LDLcolloquially called “bad” cholesterol because in excessive amounts it causes plaques in the arteries; and high-density lipoproteins, or HDLconsidered “good” cholesterol because it helps reduce the risk of heart disease and stroke.
Los triglycerides They are another type of fat that can contribute to the buildup of unhealthy cholesterol.
The study used data from ASPREE clinical trial (ASPiron in Reduction Events in the Elderly), which included 9,846 older adults from Australia and the United Statesall relatively healthy and without dementia at the beginning of the study. Over a 6-year follow-up, the researchers analyzed annual variations in participants’ total and LDL cholesterol (colloquially called “bad cholesterol”) levels.
The results showed that 509 people developed dementia and 1,760 experienced some type of cognitive impairment. The study found that the high fluctuations in total cholesterol and in the colesterol LDL are associated with:
- And 60% increased risk of dementia and a 23% more cognitive decline in those who had the greatest changes in total cholesterol.
- Faster declines on cognitive testsespecially in memory y reaction speedlinked to fluctuations in both total and LDL cholesterol.
- High fluctuations in levels of high-density lipoproteins (HDL cholesterol colloquially called “good” cholesterol) or triglycerides were not associated with cognitive impairment.
Dr. Sudha Seshadri, director of the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonionoted that the observational study could not show that fluctuations in cholesterol caused dementia, only that both conditions were related.
“It may not mean that the fluctuation leads to dementia. It could be a marker for something different. For example, are you picking up inconsistencies in lifestyle behaviors and are those occurring because a person is starting to have cognitive decline? We need to understand if this is causal or indicative of something different,” he said in a statement from the AHA.
The recent study presented by the American Heart Association aligns with previous research, such as the global report published in The Lancet in August of this year, which identified two new risk factors for dementia: elevated LDL cholesterol in middle age (related to 7% of cases) and untreated vision loss in older ages (2% of cases). As Infobae published, these factors were added to the 12 risk causes already known and associated with cognitive damage.
The report also stressed that dementia is not an inevitable fate, and that much of it can be prevented with changes in lifestyle and preventive medical checks.
“In the work on dementia prevention published in The Lancet 2024, it is observed that 45% are risk factors for dementia and are potentially modifiable. In that research, high LDL cholesterol has a risk burden of 7% compared to 2% for high blood pressure, 2% for smoking; 2% of diabetes, 2% of physical inactivity and 1% of obesity. This demonstrates the “very important burden that increased cholesterol has on the risk of dementia”Allegri said.
He neurologist and psychiatrist specialized in cognitive impairment of sleeppointed out that “cholesterol values can change in a patient under treatment, depending on many factors such as stress, and diet, among others. This leads to maintaining serial controls of serum values and identifying factors that destabilize the patient in order to also work on them and achieve more effective therapy.”
For Allegri, it is essential to design preventive strategies that address up to the 45% of modifiable dementia casesthrough actions such as improve education and control risk factors such as hearing and vision loss, head trauma, high cholesterol, hypertension, obesity, diabetes, smoking, alcohol consumption, depression, social isolation, physical inactivity and environmental pollution.
However, he stressed the relevance of considering local data: “In the study from our Fleni group, we show that Modifiable dementia risk factors in Argentina are higher, reaching 60% and have increased significantly in the 10 years of the observed period.”
Therefore, he stated that it is essential to consider regional data to develop public health campaigns and reduce the risk of dementia in older adults.
Although the doctor Corral distanced itself from the postulate of the study presented in Chicago, that cholesterol fluctuations over the years could be a biomarker of dementia risk, it did highlight the importance of control cholesterol levels to prevent cardiovascular risk and therefore the probability of cognitive impairment.
“When we talk about cognitive deterioration and dementia, which is what many patients fear, we must evaluate what the causes are. And there we have two large groups: one is Alzheimer’s disease, which does not have a defined cause, and another is the causes of dementia is the vascular causewhich is increasing in the world.”
The vascular cause causes The small arteries of the brain that carry oxygen to the neurons become clogged and obstructed, Corral defined. and added: “In those cases, doctors have two things to do: prevention and treatment.”
How can vascular damage that causes cognitive impairment be prevented? “With healthy habits, physical activity, healthy food, good rest, avoiding stress and controlling cardiovascular risk factors. I reiterate that everything that helps the heart, helps the brain. That is why it is key to lower cholesterol, blood pressure and blood glucose levels, that is, control all cardiovascular risk factors,” summarized Corral.
