High cholesterol in midlife linked to later-life dementia

An increasing number of studies have found a significant link between higher cholesterol levels in midlife and Alzheimer's disease and dementia in later life. Swap fatty foods for healthier options this Christmas and get tested now, says a leading testing expert.

There’s bad news for those of us planning to eat lots of treats over Christmas. High cholesterol levels in middle age can increase the risk of developing Alzheimer’s disease and dementia in our later years by up to 40%. Alzheimer's/dementia is the leading cause of death in England. 

A leading medical expert has been analysing the latest research and is now calling for cholesterol level testing for everyone aged 40-60 to help reduce their chances of developing dementia or Alzheimer’s when they are older.

Dr Avinash Hari Narayanan (MBChB), Clinical Lead at London Medical Laboratory, says: ‘The link between high cholesterol levels in middle age and the later onset of dementia now seems to be proven. A wealth of research points to the fact that high – or even moderately elevated – cholesterol in midlife is associated with an increased risk of Alzheimer's disease or vascular dementia. 

‘That’s hugely significant, as preventative measures for these life-altering conditions have traditionally started only later in life. Now we can test people in their 50s and assess their diets and lifestyles to manage or even reduce the risk of future dementia and Alzheimer's disease.

‘It means, however, that in order to reduce the risk of cognitive decline, action must be taken before the onset of high cholesterol levels. Behavior modification and lifestyle changes are essential to address the dementia epidemic.

‘Anyone planning to feast on red meat, such as beef, pork or lamb, this Christmas may want to think again. Traditional treats such as pigs in blankets are particularly problematic, as sausage and bacon are both processed meats high in saturated fats. Sadly, full-fat dairy, including cream, whole milk and butter, should also be reduced this Christmas, as these foods are known to increase the risk of high cholesterol.

‘Why exactly does high cholesterol increase the risk of dementia? This year, breakthrough research by the Heart Research Institute UK has found LDL, so-called “bad” cholesterol, aggregates a protein called “tau” between neurons, which cross the blood-brain barrier and can lead to dementia. The Institute claims up to 40% of a person’s dementia risk can be attributed to modifiable risk factors such as diet. It says: “This is the first time we’ve been able to say cat­e­gor­i­cal­ly that there’s a direct link between what we eat and our cog­ni­tive decline.”

‘This finding mirrors earlier research, published in the journal Neurology, which found high midlife cholesterol levels increased the risk of developing Alzheimer's disease three decades later. Worryingly, this research also found that even moderately elevated cholesterol in midlife was associated with an increased long-term risk of Alzheimer's. It found midlife cholesterol values higher than just 220 mg/dl (5.6mmo/L) increased the risk of developing Alzheimer’s three decades later. Traditionally, cholesterol levels over 240 mg/dl (6.2 mmol/L) have been considered high, so this level is concerningly lower.

‘A separate study, also published in Neurology, monitored the cholesterol levels of 8,845 participants between 1964 to 1973, when they were between the ages of 40 and 44. When these people were studied again in the 2000s, it was clear that, for some, the presence of multiple cardiovascular risk factors at midlife had substantially increased their risk of late-life dementia. Smoking, hypertension, high cholesterol and diabetes at midlife were each associated with a 20-40% increased risk of dementia in later years, with high cholesterol and diabetes being the most significant risk factors.

‘Clearly, there is a need for expanded cholesterol level testing to rapidly identify who is at risk, across all age groups. Current testing policy is largely based around treating cardiovascular problems, rather than as a preventative treatment for dementia. Cholesterol testing and subsequent treatment plans and lifestyle advice will need to be adapted, based around more holistic decision-making. Testing routines must consider not only the risk of heart attacks and strokes, but also dementia, Alzheimer’s disease and other health issues. With GP surgeries extremely busy at this time of year, it’s important to recognize that there are alternatives. The most common options are finger-prick cholesterol blood tests, which can be taken at home or at many local community pharmacies.

‘London Medical Laboratory’s revolutionary and convenient home finger-prick Cholesterol Profile test measures total cholesterol, LDL “bad cholesterol”, HDL “good” cholesterol, non-HDL (a newly adopted, more accurate, measure) and other key markers. It can be taken at home through the post, or at one of the many drop-in clinics that offer these tests across London and nationwide in over 95 selected pharmacies and health stores.