|March 14, 2002
Bad for Brain Too, UCSF Study Says
Higher cholesterol levels are not only bad for the heart
and blood vessels, they increase the risk of cognitive impairment, the precursor to
Alzheimer's disease, according to a study of elderly women by UCSF researchers. Also,
women who used cholesterol-lowering drugs called statins scored higher on tests of basic
cognitive skills, such as memory, attention, and language, according to lead author
Kristine Yaffe, MD, UCSF assistant professor of psychology, neurology and epidemiology,
and chief of geriatric psychiatry at San Francisco Veterans Affairs Medical Center.
"The higher cholesterol these women had, the worse they did on cognitive testing.
And using statins, which reduce cholesterol, seemed to be beneficial to their performance
on these tests," Yaffe said. Declining scores on cognitive tests are a symptom of
early stage Alzheimer's disease, she said.
"These results fit with other studies showing that statins may help to prevent
Alzheimer's disease," Yaffe added. Although statins have not been proven to help the
brain in a clinical trial, she explained, studies that have looked back at patients who
took statins suggest they can reduce risk of Alzheimer's. The current study is published
in the latest issue of Archives of Neurology.
To look at cholesterol's effects on the brain, Yaffe and her colleagues analyzed data
retrospectively on 1037 women who had participated in the HERS clinical trial of hormone
replacement therapy, because the trial had collected data on both cholesterol levels over
time and tests of cognitive function. The women completed tasks that measured their
abilities in memory, attention, language, orientation, and visual-spatial skills. Women
with the highest LDL-cholesterol levels, and those with the highest total cholesterol
levels, had significantly poorer test scores, even after statistically correcting for
differences such as age, education, and their use of hormone replacement therapy. Also,
women whose cholesterol levels decreased over the four years of the study were less likely
to suffer from cognitive impairment, defined as scoring especially low on the tests.
Cholesterol in general, and LDL cholesterol in particular, are well known for their
sinister effects on the heart and blood vessels - high levels lead to narrowing of the
arteries and increased risk of heart disease. HDL cholesterol is known as "good"
cholesterol because high levels seem to protect against heart attack. In addition to
clogging arteries, and possibly leading to vascular changes in the brain, cholesterol may
promote the clumping of a protein called beta-amyloid, which is believed to damage the
brain in Alzheimer's disease patients.
Yaffe doesn't encourage people to start taking statins to prevent Alzheimer's.
"Until we see the results of a randomized clinical trial, people shouldn't be taking
statins for that purpose. However, if someone has high LDL or total cholesterol, they may
be prescribed statins anyway to prevent heart disease," she said. Adopting a low
cholesterol diet is the other proven and highly recommended way for people to reduce
cholesterol to healthier levels, she added.
Co-investigators on the study included: Deborah Grady, MD, MPH, UCSF professor and vice
chair of epidemiology and biostatistics, and SFVAMC physician; Feng Lin, statistician in
UCSF's department of epidemiology and biostatistics; and Elizabeth Barrett-Connor, MD,
professor in the department of community and family medicine at University of California,
San Diego. The study was supported by grants from Wyeth-Ayerst, Inc., and the National
Institutes of Health.
UCSF News Source: Kevin Boyd