APOE genotype, cholesterol level, lipid-lowering treatment, and dementia: the Three-City Study
Dufouil C, Richard F, Fiévet N, Dartigues JF, Ritchie K, Tzourio C, Amouyel P, Alpérovitch A.. Neurology, 2005-05-01
Topic: Amyloid, tau and blood-test diagnosis
Objective To examine the association of plasma cholesterol levels, lipid-lowering agent (LLA) intake, and APOE genotype with dementia prevalence. Methods The Three-City Study is a population-based cohort of 9,294 subjects selected from the electoral rolls of three French cities (Bordeaux, Dijon, Montpellier). Baseline examination included extensive assessment of exposure to vascular risk factors (including cholesterol levels and LLA use [statin or fibrate]) and clinical diagnosis of dementia. Results Two percent of participants were demented at baseline. Overall 32.4% of participants had hyperlipidemia, and 15.6% were prescribed statins and 13.7% fibrates. After adjusting for age, gender, education level, and study center, the odds ratio (OR) for dementia was observed to be lower among LLA users (OR = 0.61, 95% CI = 0.41 to 0.91) compared with subjects taking no LLAs. There was no differential effect between statin and fibrate users. The odds for dementia were increased in subjects with hyperlipidemia (OR = 1.43, 95% CI = 1.03 to 1.99). Further adjustment for potential confounders did not modify these associations. In addition, the association between LLA intake and dementia was not modified by APOE genotype, whereas hyperlipidemia was significantly associated with increased dementia prevalence only in non-epsilon4 carriers and non-Alzheimer disease cases. Finally, in participants taking LLAs, the odds for dementia were decreased only in those having normal lipid levels. Conclusions This observational study provides further evidence that lipid-lowering agents are associated with decreased risk of dementia, whereas hyperlipidemia is associated with increased odds for non-Alzheimer-disease-type dementia. These effects appear to be independent of all major potential confounders.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Dufouil, C., Richard, F., Fiévet, N., Dartigues, J. F., Ritchie, K., Tzourio, C., et al. (2005). APOE genotype, cholesterol level, lipid-lowering treatment, and dementia: the Three-City Study. Neurology. https://doi.org/10.1212/01.wnl.0000160114.42643.31
Vancouver
Dufouil C, Richard F, Fiévet N, Dartigues JF, Ritchie K, Tzourio C, et al. APOE genotype, cholesterol level, lipid-lowering treatment, and dementia: the Three-City Study. Neurology. 2005. doi:10.1212/01.wnl.0000160114.42643.31. PMID: 15883313.
BibTeX
@article{dufouil2005-15883313,
author = {Dufouil, C. and Richard, F. and Fiévet, N. and Dartigues, J. F. and Ritchie, K. and Tzourio, C. and Amouyel, P. and Alpérovitch, A.},
title = {{APOE genotype, cholesterol level, lipid-lowering treatment, and dementia: the Three-City Study}},
journal = {Neurology},
year = {2005},
doi = {10.1212/01.wnl.0000160114.42643.31},
pmid = {15883313},
url = {https://doi.org/10.1212/01.wnl.0000160114.42643.31}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results Two percent of participants were demented at baseline.
- Overall 32.4% of participants had hyperlipidemia, and 15.6% were prescribed statins and 13.7% fibrates.
- After adjusting for age, gender, education level, and study center, the odds ratio (OR) for dementia was observed to be lower among LLA users (OR = 0.61, 95% CI = 0.41 to 0.91) compared with subjects taking no LLAs.
- In addition, the association between LLA intake and dementia was not modified by APOE genotype, whereas hyperlipidemia was significantly associated with increased dementia prevalence only in non-epsilon4 carriers and non-Alzheimer disease cases.
- Conclusions This observational study provides further evidence that lipid-lowering agents are associated with decreased risk of dementia, whereas hyperlipidemia is associated with increased odds for non-Alzheimer-disease-type dementia.
Why it matters
In this French population study, people taking cholesterol-lowering drugs were less likely to have dementia, while those with high cholesterol were more likely to have it. This kind of study can only show an association, not that these drugs prevent or treat Alzheimer's disease.
New to this subject? Start with our plain-English guide: Genetics →
Study details
- Participants9,294
- Effect size32.4%; 15.6%; 13.7%
- Evidence strengthModerate
How this study scored 61/100
Published in a leading specialty journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2005 — older than 20 years, still counted |
| Sample size | 3 / 4 | 9,294 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 228 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.9 citations a year over 23 year(s) since 2005 |
| Impact for its field and year | 4 / 6 | Cited 14.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 14 other studies in this library |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Annick Alpérovitch: h-index 79 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Inserm: institution h-index 1,988 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15883313) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 61 / 100 | — |
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