Christiane Reitz BW.indd

Context. The relation between plasma lipids, Alzheimer’s disease and vascular dementia, and the impact of lipid lowering drugs remains unclear. Objective. To investigate the relation between plasma lipid levels and the risk of Alzheimer’s disease and vascular dementia, and the impact of lipid lowering drugs on this relationship. Design and Setting. Cross-sectional and prospective community-based cohort studies. Participants. Random sample of 4316 Medicare recipients, 65 years and older, residing in northern Manhattan. Main Outcome Measures. Vascular dementia and Alzheimer’s disease according to standard criteria. Results. Elevated levels of non-HDL cholesterol and LDL as well as decreased levels of HDL were weak risk factors for vascular dementia in either cross-sectional or prospective analysis. Higher levels of total cholesterol were associated with a decreased risk of incident Alzheimer’s disease after adjustment for demographics, APOE genotype and cardiovascular risk factors. Treatment with lipid lowering drugs did not change the disease risk of either disorder. Conclusion. We found a weak relation between non-HDL cholesterol, LDL and HDL levels and the risk of vascular dementia. Lipid levels and the use of lipid lowering agents do not seem to be associated with the risk of Alzheimer’s disease.