CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

December 14th, 2010

Study Finds Inverse Correlation Between HDL and Alzheimer’s

High levels of HDL are linked to a lower risk for Alzheimer’s disease (AD), according to a new study published in Archives of Neurology. Researchers at Columbia University followed 1,130 Medicare recipients in New York City with no cognitive impairment. After 4,469 person-years of follow-up, they identified 101 cases of AD (89 probable and 12 possible). High HDL was associated with a reduced risk for AD after adjusting for age, sex, education, ethnicity, and APOEe4 genotype.

The authors caution that their results may not apply to other populations: “An important consideration in the interpretation of the results is that it was conducted in an urban multiethnic elderly community with a high prevalence of risk factors for mortality and dementia. Thus, our results may not be generalizeable to cohorts with younger individuals or to cohorts with participants with a lower morbidity [disease] burden.”

Categories: Prevention, Vascular
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2 Responses to “Study Finds Inverse Correlation Between HDL and Alzheimer’s”

  1. Nate Lebowitz, MD says:
    December 15, 2010 at 10:11 pm

    The question is whether the high level of HDL was mechanistically protective against Alzheimer’s Dementia or whether it was simply an identifier of healthier people. i.e., thinner people with better diets have lower triglyceride levels and less diabetes, which both lead to higher HDL cholesterol. Healthier people also tend to exercise more, also leading to higher HDL levels. To some degree, the adjustment for education level may get around some of this, but it is a hallmark of Medicare population observational studies that the statistical association versus direct causation problem can be misleading.

  2. Barry Smith, Ph.D. says:
    December 31, 2010 at 1:39 pm

    The HDL-Alzheimer’s association in this study is clearly correlational, not necessarily causal. However, growing evidence suggests that there may be a cause-effect relationship. For example, Ward et al. (2010) have recently shown that low HDL is also associated with reduced gray matter volume in healthy adults. This correlation suggests that long-standing low HDL may contribute to an ongoing neurodegenerative process. However, prospective data are needed to confirm these associations.

    Competing interests pertaining specifically to this post, comment, or both:
    No conflicts of interest.