A new study links cholesterol to dementia. It specifically says too much or too little of the HDL or so-called “good” part of cholesterol may contribute to dementia in older adults.
KERA’s Sam Baker recently spoke with Dr. Donna Newsome, a neurologist Texas Health Presbyterian Hospital Plano, about what cholesterol affects brain health.
Newsome: As a neurologist, my main concern with cholesterol is the risk factor in the blood vessels leading to the brain specifically, which can cause a stroke and things of that nature.
Everybody needs cholesterol. But you don't want to have too much cholesterol because it just messes up your arteries.
Baker: And this study found that maybe too little cholesterol in older adults may also contribute to dementia.
Newsome: The study says, “Well if you get too much of it, it can be bad, or increases your risk of possibly having dementia if you have too little that as well.” And it's like, so what's the happy medium? That was one thing that I was having difficulty figuring out what I was reading through this article. Even the study authors themselves said, “Well, we're not too sure if this is significant enough, but we do know that HDL, which is high lipoprotein cholesterol, is a part of brain health.” But what exactly things we're still not quite sure yet.
Baker: The study followed more than 180,000 people averaging around 70 years of age. Now, does age contribute to this problem?
Newsome: As we get older, we see that you're going to have an increased risk of all medical conditions, including dementia. So now that we're all living older - 70s, 80s, 90s - you're going to see more and more people having dementia, too.
So is that just because are we getting older or is it because of our lifestyle or is it because of the environment? Yes, yes, and yes.
I mean, some of it is definitely also genetic. We know for the most part you can pick your friends, but not your family. So, if your family members have an increased risk or you see a lot of people with their memories of heart disease, strokes, dementia, whatever, there's a pretty good chance that you have a risk factor for that somewhere genetically.
But now we're trying to figure out what else we can possibly modify that can possibly decrease our chances of having dementia. And is it to have your cholesterol levels basically pristine?
You know, if someone's having heart disease or strokes, we want that bad cholesterol, LDL to be less than 110. We would like less than 80. And you want your HDL above 60, maybe above 80. What does that mean we need actually, the HDL, more so than just the LDL. That part, I still don't know.
Baker: Back to too much may be bad, too little may be bad. What is that sweet spot? And how is a person supposed to keep cholesterol in that range or even know that it's in or out of it? I imagine most people have no idea what their cholesterol level is until the annual physical.
That's true. I mean, that's why you need to go at least once a year to see what your total cholesterol, your LDL, and HDL, and make sure you're in the quote-unquote, healthy ranges, particularly if you do have risk factors for heart disease and strokes and dementia and other disorders. That's the first issue.
We know kind of the sweet spot for the LDL, and we thought we knew this for HDL. But if you look at this study, you're like, what is the sweet spot? Are you too high or is it too low? Which one is it? That's just the thing we don't know.
Baker: So I guess, in the meantime, we're supposed to pay attention to the overall cholesterol number.
Newsome: You still look at all three. That's still very much important.
Baker: Besides the physical, is there any means that the average person would have of keeping track of cholesterol?
Newsome: The main thing you can do, hopefully, if you’re not genetically predisposed to having high levels of cholesterol, would be your diet. We know what we're supposed to eat.
- Low fatty foods
- Stay away from red meat
- More fish and chicken
- Fresh vegetables
- Don’t drink alcohol every single day in large quantities.
- Exercise regularly
We know these things. All those, if you do it properly, will hopefully decrease your risk of having dementia. Physical activity definitely decreases your risk of having dementia.
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