CHANGES IN LOW-DENSITY LIPOPROTEIN CHOLESTEROL AND SUBSEQUENT RISK OF DEMENTIA: A NATIONWIDE COHORT STUDY
Author(s)
Sung Min Kim, PhD1, Sang Min Park, MD, MPH, PhD2.
1Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, Korea, Republic of, 2Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea, Republic of.
1Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, Korea, Republic of, 2Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea, Republic of.
OBJECTIVES: Low-density lipoprotein cholesterol (LDL-C) is routinely captured in health examinations and may support dementia risk stratification, but most studies have relied on single lipid measurements. We evaluated whether within-person changes in LDL-C were associated with incident dementia among adults not using lipid-lowering agents.
METHODS: Using the Korean National Health Insurance Service database, we identified 13,548,059 adults who underwent at least two health examinations in 2009-2010 and 2011-2012 and did not use lipid-lowering agents during this period. Changes in LDL-C between examinations were categorized as <−15 mg/dL, −15 to −5 mg/dL, −4.9 to 4.9 mg/dL (stable), 5 to 15 mg/dL, and >15 mg/dL. Participants were followed for up to eight years. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for overall dementia and Alzheimer’s disease.
RESULTS: During follow-up, 179,381 incident dementia cases were identified, including 158,477 cases of Alzheimer’s disease. Compared with stable LDL-C levels, decreases greater than 15 mg/dL were associated with higher risks of overall dementia (aHR 1.06, 95% CI 1.04-1.08) and Alzheimer’s disease (aHR 1.07, 95% CI 1.05-1.09). Increases exceeding 15 mg/dL were also associated with higher risks of overall dementia (aHR 1.05, 95% CI 1.03-1.07) and Alzheimer’s disease (aHR 1.05, 95% CI 1.03-1.07).
CONCLUSIONS: In this nationwide real-world cohort, both large decreases and increases in LDL-C were associated with modestly higher dementia risk compared with stable levels. Longitudinal lipid patterns captured in routine health data may add information for dementia risk assessment, although findings should be interpreted as observational associations.
METHODS: Using the Korean National Health Insurance Service database, we identified 13,548,059 adults who underwent at least two health examinations in 2009-2010 and 2011-2012 and did not use lipid-lowering agents during this period. Changes in LDL-C between examinations were categorized as <−15 mg/dL, −15 to −5 mg/dL, −4.9 to 4.9 mg/dL (stable), 5 to 15 mg/dL, and >15 mg/dL. Participants were followed for up to eight years. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for overall dementia and Alzheimer’s disease.
RESULTS: During follow-up, 179,381 incident dementia cases were identified, including 158,477 cases of Alzheimer’s disease. Compared with stable LDL-C levels, decreases greater than 15 mg/dL were associated with higher risks of overall dementia (aHR 1.06, 95% CI 1.04-1.08) and Alzheimer’s disease (aHR 1.07, 95% CI 1.05-1.09). Increases exceeding 15 mg/dL were also associated with higher risks of overall dementia (aHR 1.05, 95% CI 1.03-1.07) and Alzheimer’s disease (aHR 1.05, 95% CI 1.03-1.07).
CONCLUSIONS: In this nationwide real-world cohort, both large decreases and increases in LDL-C were associated with modestly higher dementia risk compared with stable levels. Longitudinal lipid patterns captured in routine health data may add information for dementia risk assessment, although findings should be interpreted as observational associations.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH129
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Neurological Disorders