Could It Be Dementia?

Confounded I am.

There is a bit of positive news today (amidst all the sturm und drang in the Middle East). In Forbes online, the headline is “Alzheimer’s ‘Risk Score’ Spots Those Most Vulnerable.” http://www.forbes.com/forbeslife/health/feeds/hscout/2006/07/17/hscout533826.html

Excellent! If you find that you might be more vulnerable, you can start worrying incessantly about it. OR… there might be something you can do to change the odds.

Now the problem. There is a bit in the piece that confuses me. I thought maybe it was a trick paragraph, and further down in the article it would say “Gotcha! If you were confused by that paragraph, you’re in big trouble.” So I read it four or five times, and I’m still confused. After the article commented on two studies (lose weight, exercise, don’t get diabetes, keep your cholesterol down, etc.), there came a summary of a third study. Here’s the paragraph:

“In men who developed dementia, cholesterol levels declined at least 15 years prior to the diagnosis and remained lower. A decline in total cholesterol levels may correlate with the early stages of dementia, the authors concluded.”

My cholesterol is down; has been for 10 years – thanks to Lipitor, then Lovastatin. Does this mean in five more years, whammo? Since this “third study” seems to contradict the other studies, I decided to dig deeper. Again I learned that more is not necessarily more clear. Here, from the horse's mouth:

Decline in cholesterol levels may be associated with early stage dementia

Seeking heart health links to the development of dementia, Lenore Launer, Ph.D., of the National Institute on Aging, Bethesda, Md., and colleagues analyzed cholesterol data from a cohort of men that have been followed for 32 years, first as a part of the Honolulu Heart Program, and later as a part of the Honolulu Asia Aging Study.

“We wanted to examine the trajectory in cholesterol levels over time because some research has suggested that elevated cholesterol may increase the risk for Alzheimer’s,” explained Launer. “However, studies of this relationship have been inconsistent, some showing an association and others not. We hypothesized that one reason for the inconsistency is that cholesterol levels change with age and are affected by illness, and possibly by the dementia process itself.”

The researchers examined data from 1,027 Japanese-American men who had total cholesterol levels assayed on five occasions between 1965 and 1993 and were screened for dementia on two occasions between 1991 and 1996.

They found that cholesterol levels in men who developed dementia, and in particular those with Alzheimer’s, had declined at least 15 years before the diagnosis and remained lower than men without dementia throughout that period. The difference remained even after adjustment for potential confounding factors including vascular risk factors, weight change, alcohol intake and lipid lowering agents.

“A decline in serum total cholesterol levels may be associated with early stages in the development of dementia,” Launer said.

I reckon there is a hint of clarification in the line: “The difference remained even after adjustment for potential confounding factors including … lipid lowering agents.” But not much clarification, right? Check out the piece at:
http://www.alz.org/icad/newsreleases/071606_9am_riskfactorsone.asp

And stay alert. Ask your doc to whip up your Alzheimer’s Risk Factor Score. And watch your cholesterol level suspiciously.

If I stumble on clarification, I’ll put it right here. You betcha.

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