High and Low HDL Cholesterol Levels Linked to Dementia Risk

Kelli Whitlock Burton

October 12, 2023


High and low levels of high-density lipoprotein cholesterol (HDL-C) but not levels of low-density lipoprotein cholesterol (LDL-C) are associated with an increased risk for dementia in older adults, a new study found.


  • Electronic health record and survey data on 184,367 Kaiser Permanente Northern California participants (median age 69.5 years) with no history of dementia were taken.

  • Cholesterol levels were measured within 2 years of survey completion.


  • There were 25,214 incident cases of dementia reported over an average follow-up of 8.77 years.

  • Dementia risk was significantly higher in people with low HDL-C (11-41 mg/dL; adjusted hazard ratio [aHR], 1.07; 95% CI, 1.03-1.11) and high HDL-C (> 65 mg/dL; aHR, 1.15; 95% CI, 1.11-1.20).

  • The study demonstrates an association between low and high levels of "good" cholesterol but not a causal link.

  • There was no significant association between LDL-C and dementia risk.


"These results support the conclusion that some lipoproteins may be modifiable risk factors for dementia, even in late life," the authors write.


The study was conducted by Erin L. Ferguson, MPH, Department of Epidemiology & Biostatistics, University of California, San Francisco, California, and was funded by the National Institutes of Health. It was published online October 4, 2023 in Neurology.


There were no adjustments for APOE status and confounding and selection bias.


The authors report no relevant disclosures.

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