TY - JOUR
T1 - Association between Triglycerides and Risk of Dementia in Community-Dwelling Older Adults
T2 - A Prospective Cohort Study
AU - Zhou, Zhen
AU - Ryan, Joanne
AU - Tonkin, Andrew M.
AU - Zoungas, Sophia
AU - Lacaze, Paul
AU - Wolfe, Rory
AU - Orchard, Suzanne G.
AU - Murray, Anne M.
AU - McNeil, John J.
AU - Yu, Chenglong
AU - Watts, Gerald F.
AU - Hussain, Sultana Monira
AU - Beilin, Lawrence J.
AU - Ernst, Michael E.
AU - Stocks, Nigel
AU - Woods, Robyn L.
AU - Zhu, Chao
AU - Reid, Christopher M.
AU - Shah, Raj C.
AU - Chong, Trevor T.J.
AU - Sood, Ajay
AU - Sheets, Kerry M.
AU - Nelson, Mark R.
N1 - Funding Information:
Z. Zhou reported receiving salary from the RACGP/HCF Research Foundation Research Grant to lead this study. A.M. Tonkin reported receiving research support or honoraria from Amgen, Boehringer-Ingelheim, Merck, and Pfizer, as well as materials in the ASPREE trial from Bayer. S. Zoungas has received NHMRC and Australian Heart Foundation research funding as the principal investigator of the STAREE trial, and has received payment to the institution (Monash University) from Eli Lilly Australia, Boehringer-Ingelheim, Merck Sharp & Dohme Australia, AstraZeneca, Novo Nordisk, Sanofi, and Servier for consultancy work outside the submitted work. P. Lacaze is supported by a National Heart Foundation Future Leader Fellowship (102604). S.M. Hussain received an NHMRC Early Career Fellowship. C.M. Reid reported being funded through a National Health and Medical Research Council Principal Research Fellowship. R.C. Shah reports being the site principal investigator or subinvestigator for Alzheimer's disease clinical trials and research for which his institution (Rush University Medical Center) is compensated (Amylyx Pharmaceuticals, Inc., Athira Pharma, Inc., Eli Lilly & Co., Inc., Genentech, Inc., and Roche Holdings AG). T.T-J. Chong is supported by an Australian Research Council Future Fellowship, and has received honoraria for lectures from Roche. M.R. Nelson reported receiving honoraria from Sanofi and Amgen as well as Bayer for materials in ASPREE. The other authors declare that they have no conflicts of interest. Go to Neurology.org/N for full disclosures.
Funding Information:
This study is supported by a grant from the Royal Australian College of General Practitioners (RACGP)/HCF Research Foundation Research (HCF2021-11) and the National Institute on Aging.
Publisher Copyright:
© American Academy of Neurology.
PY - 2023/11/28
Y1 - 2023/11/28
N2 - Background and ObjectivesIt has been suggested that higher triglyceride levels were associated with a lower risk of Alzheimer disease. This study aimed to examine the association of triglycerides with dementia and cognition change in community-dwelling older adults.MethodsThis prospective longitudinal study used data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized trial of adults aged 65 years or older without dementia or previous cardiovascular events at enrollment. The main outcome was incident dementia. Other outcomes included changes in composite cognition and domain-specific cognition (global cognition, memory, language and executive function, and psychomotor speed). The association between baseline triglycerides and dementia risk was estimated using Cox proportional hazard models adjusting for relevant risk factors. Linear mixed models were used to investigate cognitive change. The analysis was repeated in a subcohort of participants with available APOE-ϵ4 genetic data with additional adjustment for APOE-ϵ4 carrier status and an external cohort (UK Biobank) with similar selection criteria applied.ResultsThis study included 18,294 ASPREE participants and 68,200 UK Biobank participants (mean age: 75.1 and 66.9 years; female: 56.3% and 52.7%; median [interquartile range] triglyceride: 106 [80-142] mg/dL and 139 [101-193] mg/dL), with dementia recorded in 823 and 2,778 individuals over a median follow-up of 6.4 and 12.5 years, respectively. Higher triglyceride levels were associated with lower dementia risk in the entire ASPREE cohort (hazard ratio [HR] with doubling of triglyceride: 0.82, 95% CI 0.72-0.94). Findings were similar in the subcohort of participants with APOE-ϵ4 genetic data (n = 13,976) and in the UK Biobank cohort (HR was 0.82 and 0.83, respectively, all p ≤ 0.01). Higher triglycerides were also associated with slower decline in composite cognition and memory over time (p ≤ 0.05).DiscussionOlder adults with higher triglyceride levels within the normal to high-normal range had a lower dementia risk and slower cognitive decline over time compared with individuals with lower triglyceride levels. Higher triglyceride levels may be reflective of better overall health and/or lifestyle behaviors that would protect against dementia development. Future studies are warranted to investigate whether specific components within the total circulating pool of plasma triglycerides may promote better cognitive function, with the hope of informing the development of new preventive strategies.
AB - Background and ObjectivesIt has been suggested that higher triglyceride levels were associated with a lower risk of Alzheimer disease. This study aimed to examine the association of triglycerides with dementia and cognition change in community-dwelling older adults.MethodsThis prospective longitudinal study used data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized trial of adults aged 65 years or older without dementia or previous cardiovascular events at enrollment. The main outcome was incident dementia. Other outcomes included changes in composite cognition and domain-specific cognition (global cognition, memory, language and executive function, and psychomotor speed). The association between baseline triglycerides and dementia risk was estimated using Cox proportional hazard models adjusting for relevant risk factors. Linear mixed models were used to investigate cognitive change. The analysis was repeated in a subcohort of participants with available APOE-ϵ4 genetic data with additional adjustment for APOE-ϵ4 carrier status and an external cohort (UK Biobank) with similar selection criteria applied.ResultsThis study included 18,294 ASPREE participants and 68,200 UK Biobank participants (mean age: 75.1 and 66.9 years; female: 56.3% and 52.7%; median [interquartile range] triglyceride: 106 [80-142] mg/dL and 139 [101-193] mg/dL), with dementia recorded in 823 and 2,778 individuals over a median follow-up of 6.4 and 12.5 years, respectively. Higher triglyceride levels were associated with lower dementia risk in the entire ASPREE cohort (hazard ratio [HR] with doubling of triglyceride: 0.82, 95% CI 0.72-0.94). Findings were similar in the subcohort of participants with APOE-ϵ4 genetic data (n = 13,976) and in the UK Biobank cohort (HR was 0.82 and 0.83, respectively, all p ≤ 0.01). Higher triglycerides were also associated with slower decline in composite cognition and memory over time (p ≤ 0.05).DiscussionOlder adults with higher triglyceride levels within the normal to high-normal range had a lower dementia risk and slower cognitive decline over time compared with individuals with lower triglyceride levels. Higher triglyceride levels may be reflective of better overall health and/or lifestyle behaviors that would protect against dementia development. Future studies are warranted to investigate whether specific components within the total circulating pool of plasma triglycerides may promote better cognitive function, with the hope of informing the development of new preventive strategies.
UR - http://www.scopus.com/inward/record.url?scp=85178497753&partnerID=8YFLogxK
UR - https://onesearch.library.uwa.edu.au/permalink/61UWA_INST/c6psno/cdi_scopus_primary_2028847064
U2 - 10.1212/WNL.0000000000207923
DO - 10.1212/WNL.0000000000207923
M3 - Article
C2 - 37879942
AN - SCOPUS:85178497753
SN - 0028-3878
VL - 101
SP - E2288-E2299
JO - Neurology
JF - Neurology
IS - 22
ER -