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Cholesterol as a risk factor for dementia and cognitive decline: a systematic review of prospective studies with meta-analysis
Anstey KJ, Lipnicki DM, Low LF.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2008-05-01
Topic: Risk, prevention and care in population studies
The relationships between total serum cholesterol (TC) and dementia and between TC and cognitive decline were investigated in a systematic review of 18 prospective studies. Follow-ups ranged from 3 to 29 years, and included a total of 14,331 participants evaluated for Alzheimer disease (AD), 9,458 participants evaluated for Vascular dementia (VaD), 1,893 participants evaluated for cognitive decline, and 4,793 participants evaluated for cognitive impairment. Compatible results were pooled using meta-analysis. Consistent associations between high midlife TC and increased risk of AD, and high midlife TC and increased risk of any dementia were found. There was no evidence supporting an association between late-life TC and AD, or between late-life TC and any dementia. No study reported a significant association between TC (measured in midlife or late-life) and VaD. An association between high midlife TC and cognitive impairment was found but there was only weak evidence for an association between TC and cognitive decline. Two of seven studies reporting data on the interaction between TC and apolipoprotein e4-allele had significant effects. Results suggest the effect of TC on dementia risk occurs in midlife but not late-life, and that there may be different cardiovascular risk factor profiles for AD and VaD. Results from additional studies involving long-term follow-up of midlife samples will allow for clarification of the association between age, TC and risk of specific types of dementia. These data are required to inform recommendations of modulation of cholesterol to reduce or delay dementia risk.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Anstey, K. J., Lipnicki, D. M., & Low, L. F. (2008). Cholesterol as a risk factor for dementia and cognitive decline: a systematic review of prospective studies with meta-analysis. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. https://doi.org/10.1097/jgp.0b013e31816b72d4
Vancouver
Anstey KJ, Lipnicki DM, Low LF. Cholesterol as a risk factor for dementia and cognitive decline: a systematic review of prospective studies with meta-analysis. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2008. doi:10.1097/jgp.0b013e31816b72d4. PMID: 18448847.
BibTeX
@article{anstey2008-18448847,
author = {Anstey, K. J. and Lipnicki, D. M. and Low, L. F.},
title = {{Cholesterol as a risk factor for dementia and cognitive decline: a systematic review of prospective studies with meta-analysis}},
journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
year = {2008},
doi = {10.1097/jgp.0b013e31816b72d4},
pmid = {18448847},
url = {https://doi.org/10.1097/jgp.0b013e31816b72d4}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Compatible results were pooled using meta-analysis.
- Consistent associations between high midlife TC and increased risk of AD, and high midlife TC and increased risk of any dementia were found.
- No study reported a significant association between TC (measured in midlife or late-life) and VaD.
- Two of seven studies reporting data on the interaction between TC and apolipoprotein e4-allele had significant effects.
- Results suggest the effect of TC on dementia risk occurs in midlife but not late-life, and that there may be different cardiovascular risk factor profiles for AD and VaD.
Why it matters
This review of 18 prospective studies found that high cholesterol in midlife was linked to higher risk of Alzheimer's disease and any dementia, but no link was found for cholesterol measured in late life. No study found a significant association between cholesterol and vascular dementia.
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Study details
- Study designsystematic review
- Participants14,331
- Evidence strengthHigh
How this study scored 61/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry) |
| Journal's citation record | 2 / 4 | American Journal of Geriatric Psychiatry: journal h-index 178 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 4 / 4 | 14,331 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 4 / 7 | Cited 86 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.3 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 2 / 6 | Cited 2.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 1 / 4 | Cited 10 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Lee‐Fay Low: h-index 46 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | UNSW Sydney: institution h-index 1,101 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18448847) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 61 / 100 | — |
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