| BackgroundWith the aging of global population,the prevalence of dementia increased significantly.In China,the latest estimate of the prevalence of dementia is 6.0%among older adults aged 60 years and above.Dementia has brought about heavy economic and social burden to the world and the treatment of dementia has become an urgent need.In the case of lacking of available treatment methods,more and more researchers shift attention to the modifiable risk factors which play an important role in preventing dementia.It has become a consensus to propose prevention strategies by controlling modifiable risk factors in people with cognitive impairment,to delay or even prevent the onset of dementia.As a common biochemical indicator in hematological examination,dyslipidemia is closely related to the onset of dementia through various pathophysiological mechanisms.However,the relationship between late-life dyslipidemia and dementia has not achieved consistency in relevant research.Therefore,it is worth exploring the association of dyslipidemia with cognitive decline and incident dementia in late-life.ObjectiveWe aimed to explore the association of dyslipidemia with all-cause of dementia,Alzheimer’s disease(AD),and vascular dementia(VaD)among rural-dwelling older adults,while taking into account the potential role of age.MethodsThis longitudinal population-based study targeted 3277 people(aged 60 years and above,57.8%women)from Shandong Yanggu study of Aging and Dementia(SYS-AD)from 2014 to 2015.Follow-up examinations were performed based Multidomain Interventions to Delay Dementia and Disability in Rural China(MIND-China)during 2018,which including physical examination,laboratory tests,questionnaires,and so on.Out of the 3277 participants,1945(59.4%)were invited to take part in follow-up analysis.After defining dyslipidemia according to 2016 Chinese Guidelines for the Management of Dyslipidemia in Adults,we explored the association between dyslipidemia and incident dementia using the Cox proportional hazards models and assessed the associations between dyslipidemia and cognitive decline using the multivariable linear regression models.ResultsAfter an average of 3.7 years of follow-up,97 out of 1945 participants have developed dementia,including 68 AD and 28 VaD.In total sample,dyslipidemia was not significantly associated with incidence of dementia,AD,or VaD in the whole sample(P>0.05).But there is an interaction between dyslipidemia and age in the impact on the onset of dementia and cognitive decline(P<0.05).Only in younger people aged less than 70 years old,dyslipidemia at baseline can significantly increase the risk of VaD(HR=5.72,95%CI=1.13-28.87,P<0.01)and association of dyslipidemia with incidence of all-cause dementia being significant before adjusting for vascular risk factors(HR=2.43,95%CI=1.09-5.39,P<0.05).However,among the elderly aged 70 years and above,the association of lipid concentrations at baseline with 3.7-year incident dementia and cognitive decline was not significant(P>0.05).ConclusionThe association of dyslipidemia with incidence of all-cause dementia and VaD existed only in younger elderly(age<70 years),but not the older elderly(age≥70 years).Serum lipid components were not associated with the risk of dementia and its subtypes and cognitive decline.The pathophysiological mechanism underlying the age-dependent association of dyslipidemia with incidence of VaD is still warranted to be explored. |
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