Introduction: Although increased cholesterol level has been acknowledged as a risk factor for dementia, evidence synthesis based on published data has yielded mixed results. This is especially... Show moreIntroduction: Although increased cholesterol level has been acknowledged as a risk factor for dementia, evidence synthesis based on published data has yielded mixed results. This is especially relevant in older adults where individual studies report non-linear relationships between cholesterol and cognition and, in some cases, find higher cholesterol associated with a lower risk of subsequent cognitive decline or dementia. Prior evidence synthesis based on published results has not allowed us to focus on older adults or to standardize analyses across studies. Given our ageing population, an increased risk of dementia in older adults, and the need for proportionate treatment in this age group, an individual participant data (IPD) meta-analysis is timely. Method: We combined data from 8 studies and over 21,000 participants aged 60 years and over in a 2-stage IPD to examine the relationship between total, high-density, and low-density lipoprotein (HDL and LDL) cholesterol and subsequent incident dementia or cognitive decline, with the latter categorized using a reliable change index method. Results: Meta-analyses found no relationship between total, HDL, or LDL cholesterol (per millimoles per litre increase) and risk of cognitive decline in this older adult group averaging 76 years of age. For total cholesterol and cognitive decline: odds ratio (OR) 0.93 (95% confidence interval [CI] 0.86: 1.01) and for incident dementia: OR 1.01 [95% CI 0.89: 1.13]. This was not altered by rerunning the analyses separately for statin users and non-users or by the presence of an APOE e4 allele. Conclusion: There were no clear consistent relationships between cholesterol and cognitive decline or dementia in this older adult group, nor was there evidence of effect modification by statin use. Further work is needed in younger populations to understand the role of cholesterol across the life-course and to identify any relevant intervention points. This is especially important if modification of cholesterol is to be further evaluated for its potential influence on risk of cognitive decline or dementia. Show less
Introduction: The ageing process can be influenced by different dietary patterns and dietary factors.Aim: To analyse the association of dietary factors, which include the Mediterranean diet... Show moreIntroduction: The ageing process can be influenced by different dietary patterns and dietary factors.Aim: To analyse the association of dietary factors, which include the Mediterranean diet adherence, the compliance with the "Sociedad Espanola de Nutricion Comunitaria" food portion recommendations, and the intake of different food groups, with the secreted form of the alpha-Klotho gene (S-Klotho as an anti-ageing marker) in middle-aged sedentary adults.Methods: A total of 74 (39 women) middle-aged sedentary adults participated in the study. Dietary factors were assessed with a food frequency questionnaire and the PREDIMED questionnaire. The S-Klotho plasma levels were measured using a soluble alpha-Klotho ELISA assay kit.Results: We observed: (i) a negative association between the adherence to the Mediterranean diet and the S-Klotho plasma levels (beta = - 53.219; R-2 = 0.078; P = 0.020), (ii) a higher intake of wine (> 7 glasses/week), was associated with lower S-Klotho plasma levels (P = 0.039), and (iii) a positive association between nuts portion intake and the S-Klotho plasma levels (beta = 26.087; R-2 = 0.070; P = 0.029). All the associations disappeared after controlling for lean mass index (LMI) (all P > 0.05).Conclusion: Our study suggests that, although dietary factors could be related to S-Klotho plasma levels in middle-aged sedentary adults, LMI is the main determinant in this regard. Show less
Kolk, A.; Zwaal, P. van der; Thomassen, B.J.W.; Kamp, E.W.C. van de; Stijnen, T.; Groot, J.H. de; Nelissen, R.G.H.H. 2018
