Basic summary is that HDL and dementia risk were positively correlated with the lowest risk being at an HDL<40mg/dl.
They used a variety of models to adjust and the dataset was the ASPREE trial. Average age was 75.
More editorialising by me: HDL has not been viewed as good cholesterol for a while and is viewed more neutrally however it came as a surprise to me that people outside of the normal HDL range (<40) had the lowest rates of dementia. There were differences between the groups which you can adjust for depending on which of the 5 models you think is best. The trend between HDL and dementia was there for all models.
Interesting. Another recent study with 10x more patients (184,367 vs 18,668) over a longer period of time (17y vs 6.3y) concluded that: Low- and High-Density Lipoprotein Cholesterol and Dementia Risk Over 17 Years of Follow-up Among Members of a Large Health Care Plan. This larger study was done by researchers from UCSF, while the one you cited was conducted by researchers from Monash University, the University of Western Australia, and the University of Iowa. I would tend to favor the larger study. In any case, they both agree that high HDL = bad.
I don’t have access to the study you linked so can’t see the methods and adjustments etc they used. The ASPREE dataset is well regarded and as it is an interventional trial (on aspirin) the patient measurements are considered accurate (size isn’t everything ;)). Agree that high HDL carries risk but the surprise to me was that HDL lower than the reference range was protective (ASPREE). In the study you linked both low and high HDL were linked to increased dementia risk but without looking at the adjustments, and group differences it is hard to come to a conclusion.
It would be interesting to see stratified by APOE4 status, as John Kastelein has an interesting story that apoA1 can take over the damaged functions of apoe in the brain. Hence apoA1 / HDL might be able to attenuate Alzheimer’s risk in apoe4 carriers.
The associations between HDL-C levels and incident dementia are presented in Table 2. In the group with very high HDL-C levels (>80 mg/dL) the rate of incident dementia was 81 events per 10,000 person-years compared to 69 events per 10,000 person-years amongst those with an HDL-C of 40–60 mg/dL.
Yes, it is also in the link I showed, and CETP inhibition / loss of function is interesting to look at genetically and pharmaceutically since it increases HDL / apoA1 massively.
I can only hope True Detective turns out to be half as good as Fortitude.
I just loved the anti-aging plot and the guy who played the sheriff was brilliant
