Even Moderate Elevations of Cholesterol Predispose to the Two Types of Dementia

Most people know about Alzheimer's disease but few are aware of the second most common cause of dementia, vascular dementia. That's probably because the latter condition is poorly understood and little discussed in the media. The name, however, provides a clue. The three most common mechanisms of vascular dementia are multiple brain cortical infarcts, a strategic single infarct, and small vessel disease (see: Vascular Dementia). There's now evidence that both types of dementia have a relationship to serum cholesterol and that even moderate levels of it in midlife can put you at risk (see: Study Shows Even Moderately Elevated Cholesterol Level Boosts Dementia Risk). Below is an excerpt from the article:

Elevated cholesterol levels in midlife – even levels considered only borderline elevated – significantly increase the risk of Alzheimer’s disease and vascular dementia later in life, according to a new study...(see: Midlife Serum Cholesterol and Increased Risk of Alzheimer’s and Vascular Dementia Three Decades Later).... Even borderline cholesterol levels (200 – 239 mg/dL) in midlife raised risk for late-life vascular dementia by nearly the same amount: 52 percent. Vascular dementia, the second most common form of dementia after Alzheimer’s disease, is a group of dementia syndromes caused by conditions affecting the blood supply to the brain. Scientists are still trying to pinpoint the genetic factors and lifestyle causes for Alzheimer’s disease....[T]his study is the largest long-term study with the most diverse population to examine the midlife cholesterol levels and late-life dementia. It is also the first study to look at borderline high cholesterol levels and vascular dementia, rather than just Alzheimer’s disease. “Our findings add to the existing body of evidence on a degree of overlap between two dementia types in terms of risk factors, symptoms and neuropathology,” said the study’s lead author....“Dementia and cardiovascular disease are common major health problems, share several risk factors and often occur simultaneously, interacting with one another. A holistic approach that addresses multiple major health problems simultaneously is needed to effectively manage these disorders.”

I found this article to fascinating. Many years ago, I asked my an internist friend whether it could be possible to take one's cholesterol level too low with statins, exercise, and dietary control. After all, cholesterol is a major component of cellular membranes. He said, "I'd advise anyone to try to lower it as much as possible." Now we learn, at least from the perspective of dementia and heart health, that this was sound advice. Although it's reasonable to assume that dementia and cardiovascular disease share multiple risk factors, I never had them strongly linked in my mind. However, they will remain bound together from now on. As a pathologist who has performed many autopsies, I am all too familiar with atherosclerotic plaques in the aorta, coronary arteries, and carotid arteries. Obviously, many of these patients had high cholesterol levels. In my experience, however, it was unusual to see smaller arteries with lipid deposits. However, there's still much to learn about the relationship between small vessel disease, dementia, and cholesterol levels. There's now another good reason to keep your cholesterol levels in good control.

Comments

[Stephen Guy-Clarke]

Here is another way at looking at the pathway between emotions and cholesterol which can be the precursor of more serious conditions like Alzheimers.-
Traditional Chinese Medicine (TCM) and the heart.
In TCM it is said the ‘heart houses the mind’. The heart is considered the main organ governing mental activities and its links to the brain. Put another way, there is a mutual effect and correlation between the heart dominating the vessels and the vessels supplying the mind.

To give an example of how emotional stress can have a physiological effect, here is an extract from an article published in the Daily Mail in March 2006 entitled ‘ Row with your loved one hurts the heart’ where it was reported that a three year study of older married couples found their arteries hardened and narrowed after they were involved in arguments, raising their risk of heart disease.
For women, this happened when the row took on a hostile nature. But for men it occurred only when either they or their wife acted in a dominating and controlling manner. American scientists asked 150 couples in their 60s and 70s to discuss a sore topic such as money or their in-laws for six minutes. Each conversation was observed by psychologists who gave a point score for friendly, hostile or dominant behaviour. Two days later the couples were given CAT scans to show the extent of atherosclerosis. The results revealed that the couples who had the most stormy rows showed the most signs of having narrowed arteries.
Tim Smith, Professor of Psychology at the University of Utah, said, ‘Disagreements are an unavoidable fact of relationships, but the way we talk during disagreements gives us an opportunity to do something healthy. If you were concerned about men’s heart health, you would ask couples to find ways to talk about disagreements without trying to control each other. If you were concerned about women’s heart health, you would encourage couples to find ways to have disagreements that were not hostile.’