Elevated serum total and LDL cholesterol in very old patients with Alzheimer's disease

The relationships of serum lipids with Alzheimer's disease (AD) and other d ementias in very old patients are not clear. All residents of an academic n ursing home were studied clinically for dementia and for serum lipids. All those autopsied over a 7.7-year period had apolipoprotein E (apoE) genotypi ng and detailed neuropathological examination. Those with pathologically de fined criteria for AD (n = 84) were compared to all others who also had cli nical dementia but did not show AD changes (n = 22). In contrast to most ot her reports of serum lipids in very old patients with AD, total cholesterol (TC) and low density lipoprotein cholesterol levels were each significantl y higher for those with AD. The lipid-AD associations were progressively st ronger with increasing pathological certainty of AD diagnosis. These relati onships remained significant after adjustment for apoE genotype and for oth er known risk factors. The lipid-AD associations in a very old cohort, and prior evidence that elevated TC in middle life is a risk factor for later d ementia, prompt consideration of factors associated with lipid metabolism i n the development of Alzheimer's dementia. Copyright (C) 2001 S. Karger AG, Basel.