Long-term levels of LDL-C and cognitive function: The CARDIA Study

Matthew T. Mefford, Ligong Chen, Cora E. Lewis, Paul Muntner, Stephen Sidney, Lenore J. Launer, Keri L. Monda, Andrea Ruzza, Helina Kassahun, Robert S. Rosenson, April P. Carson

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objectives: It is uncertain if long-term levels of low-density lipoprotein-cholesterol (LDL-C) affect cognition in middle age. We examined the association of LDL-C levels over 25 years with cognitive function in a prospective cohort of black and white US adults. Methods: Lipids were measured at baseline (1985-1986; age: 18-30 years) and at serial examinations conducted over 25 years. Time-averaged cumulative LDL-C was calculated using the area under the curve for 3,328 participants with ≥3 LDL-C measurements and a cognitive function assessment. Cognitive function was assessed at the Year 25 examination with the Digit Symbol Substitution Test [DSST], Rey Auditory Visual Learning Test [RAVLT], and Stroop Test. A brain magnetic resonance imaging (MRI) sub-study (N = 707) was also completed at Year 25 to assess abnormal white matter tissue volume (AWMV) and gray matter cerebral blood flow volume (GM-CBFV) as secondary outcomes. Results: There were 15.6%, 32.9%, 28.9%, and 22.6% participants with time-averaged cumulative LDL-C <100 mg/dL, 101-129 mg/dL, 130-159 mg/dL, and ≥160 mg/dL, respectively. Standardized differences in all cognitive function test scores ranged from 0.16 SD lower to 0.09 SD higher across time-averaged LDL-C categories in comparison to those with LDL-C < 100 mg/dL. After covariate adjustment, participants with higher versus lower time-averaged LDL-C had a lower RAVLT score (p-trend = 0.02) but no differences were present for DSST, Stroop Test, AWMV, or GM-CBFV. Conclusion: Cumulative LDL-C was associated with small differences in memory, as assessed by RAVLT scores, but not other cognitive or brain MRI measures over 25 years of follow-up.

Original languageEnglish
Pages (from-to)1048-1057
Number of pages10
JournalJournal of the International Neuropsychological Society
Volume27
Issue number10
DOIs
StatePublished - 10 Nov 2021

Keywords

  • Cholesterol
  • Cognition
  • Cohort studies
  • LDL
  • Lipids

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