Plasma total cholesterol level as a risk factor for Alzheimer disease: the Framingham Study
Tan ZS, Seshadri S, Beiser A, Wilson PW, Kiel DP, Tocco M, D'Agostino RB, Wolf PA.. Archives of internal medicine, 2003-05-01
Topic: Amyloid, tau and blood-test diagnosis
Background Previous studies examining the association of plasma cholesterol levels with the risk for development of Alzheimer disease (AD) have been inconclusive. We examined the impact of baseline and lifetime plasma total cholesterol levels averaged across many years on the risk for AD in a large, population-based cohort. Methods Five thousand two hundred nine subjects from the Framingham Study original cohort underwent biennial evaluation for cardiovascular risk factors since 1950, with estimations of serum total cholesterol levels at 19 of these 25 biennial examinations. The study sample consisted of 1026 subjects from this cohort who were alive and free of stroke and dementia at examination cycle 20 (1988-1989) and had undergone apolipoprotein E (APOE) genotyping. The main outcome measure was incident AD diagnosed using standard criteria, according to average total cholesterol levels across biennial examination cycles 1 to 15 and baseline total cholesterol level measured at the 20th biennial examination cycle. Results Alzheimer disease developed in 77 subjects from 1992 to 2000. After adjustment for age, sex, APOE genotype, smoking, body mass index (calculated as weight in kilograms divided by the square of height in meters), coronary heart disease, and diabetes, we found no significant association between the risk for incident AD and average cholesterol level at biennial examination cycles 1 to 15 (hazard ratio per 10-mg/dL [0.3-mmol/L] rise, 0.95; 95% confidence interval, 0.87-1.04) or baseline total cholesterol level at examination 20 (hazard ratio, 0.97; 95% confidence interval, 0.90-1.05). Conclusion In this large, population-based cohort, baseline and long-term average serum total cholesterol levels were not associated with the risk for incident AD.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Tan, Z. S., Seshadri, S., Beiser, A., Wilson, P. W., Kiel, D. P., Tocco, M., et al. (2003). Plasma total cholesterol level as a risk factor for Alzheimer disease: the Framingham Study. Archives of internal medicine. https://doi.org/10.1001/archinte.163.9.1053
Vancouver
Tan ZS, Seshadri S, Beiser A, Wilson PW, Kiel DP, Tocco M, et al. Plasma total cholesterol level as a risk factor for Alzheimer disease: the Framingham Study. Archives of internal medicine. 2003. doi:10.1001/archinte.163.9.1053. PMID: 12742802.
BibTeX
@article{tan2003-12742802,
author = {Tan, Z. S. and Seshadri, S. and Beiser, A. and Wilson, P. W. and Kiel, D. P. and Tocco, M. and D'Agostino, R. B. and Wolf, P. A.},
title = {{Plasma total cholesterol level as a risk factor for Alzheimer disease: the Framingham Study}},
journal = {Archives of internal medicine},
year = {2003},
doi = {10.1001/archinte.163.9.1053},
pmid = {12742802},
url = {https://doi.org/10.1001/archinte.163.9.1053}
}
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 Alzheimer disease developed in 77 subjects from 1992 to 2000.
- After adjustment for age, sex, APOE genotype, smoking, body mass index (calculated as weight in kilograms divided by the square of height in meters), coronary heart disease, and diabetes, we found no significant association between the risk for incident AD and average cholesterol level at biennial examination cycles 1 to 15 (hazard ratio per 10-mg/dL [0.3-mmol/L] rise, 0.95; 95% confidence interval, 0.87-1.04) or baseline total cholesterol level at examination 20 (hazard ratio, 0.97; 95% confidence interval, 0.90-1.05).
- Conclusion In this large, population-based cohort, baseline and long-term average serum total cholesterol levels were not associated with the risk for incident AD.
Why it matters
In this large population-based cohort, neither baseline nor long-term average serum total cholesterol levels were associated with the risk of developing Alzheimer disease. This null result means cholesterol level was not found to be a risk factor for Alzheimer disease in this study.
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Study details
- Participants1,026
- Evidence strengthModerate
How this study scored 55/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, so that was left out: it earned 53 of the 96 points we could judge it on, which is 55 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of internal medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| 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 | 2003 — older than 20 years, still counted |
| Sample size | 3 / 4 | 1,026 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 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 280 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.2 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 4 / 6 | Cited 9.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 25 other studies in this library |
| Still being cited | 1 / 4 | Cited 14 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Philip A. Wolf: h-index 149 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12742802) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 53 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 53 of the 96 points we could judge it on is 55 out of 100. |
| Total | 55 / 100 | — |
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