Journals of Gerontology Series A: Biological Sciences and Medical Sciences Large Type Edition
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Suryadevara, V.
Right arrow Articles by Ahn, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Suryadevara, V.
Right arrow Articles by Ahn, C.
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:M859-M861 (2003)
© 2003 The Gerontological Society of America

Association of Abnormal Serum Lipids in Elderly Persons With Atherosclerotic Vascular Disease and Dementia, Atherosclerotic Vascular Disease Without Dementia, Dementia Without Atherosclerotic Vascular Disease, and No Dementia or Atherosclerotic Vascular Disease

Vana Suryadevara1, Samantha G. Storey1, Wilbert S. Aronow1,2 and Chul Ahn3

Divisions of 1 Geriatrics
2 Cardiology, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla.
3 Department of Medicine, University of Texas School of Medicine at Houston, Houston, Texas.


   Abstract
Top
 Abstract
Methods
 Results
 Discussion
 References
 
Background. Observational data have shown that the use of statins was associated with a lower prevalence of vascular dementia and of Alzheimer's disease.

Methods. We investigated in an academic nursing home the association of dyslipidemia with atherosclerotic vascular disease (group 1), atherosclerotic vascular disease without dementia (group 2), dementia without atherosclerotic vascular disease (group 3), and no dementia or atherosclerotic vascular disease (group 4).

Results. Increased serum low-density lipoprotein (LDL) cholesterol was present in 36 of 50 group 1 patients (72%), in 34 of 50 group 2 patients (68%), in 34 of 50 group 3 patients (68%), and in 18 of 50 group 4 patients (36%) (p =.0003 for 1 versus 4; p = 0.001 for 2 versus 4 and 3 versus 4). Decreased serum high-density lipoprotein (HDL) cholesterol was present in 34 of 50 group 1 patients (68%), in 35 of 50 group 2 patients (70%), in 32 of 50 group 3 patients (64%), and in 16 of 50 group 4 patients (32%) (p =.0003 for 1 versus 4; p =.0001 for 2 versus 4; p =.001 for 3 versus 4). Hypertriglyceridemia was not significantly different in the 4 groups.

Conclusions. The prevalence of increased serum LDL cholesterol and decreased serum HDL cholesterol were significantly higher in elderly patients with atherosclerotic vascular disease plus dementia, atherosclerotic vascular disease without dementia, and dementia without atherosclerotic vascular disease than in patients with no dementia or atherosclerotic vascular disease.

DYSLIPIDEMIA is present in elderly patients with atherosclerotic vascular disease (1–13). Observational data have shown that the use of statins was associated with a lower prevalence of vascular dementia and Alzheimer's disease (14–16). Serum lipids were also similar in patients with Alzheimer's disease with or without cardiovascular disease (17). We are reporting data from a cross-sectional study of elderly patients in an academic nursing home showing the association of abnormal serum lipids with atherosclerotic vascular disease plus dementia, atherosclerotic vascular disease without dementia, dementia without atherosclerotic vascular disease, and no dementia or atherosclerotic vascular disease.


   METHODS
Top
 Abstract
 Methods
Results
 Discussion
 References
 
The study population included 200 patients, mean age 78 ± 9 years (range, 59–99 years), in an academic nursing home affiliated with New York Medical College. Atherosclerotic vascular disease was diagnosed if the patient had either coronary artery disease, prior stroke, or peripheral arterial disease as previously described (18). Dementia was diagnosed as previously described (19).

The 4 study groups included 50 patients with atherosclerotic vascular disease plus dementia, 50 patients with atherosclerotic vascular disease without dementia, 50 patients with dementia without atherosclerotic vascular disease, and 50 patients with no dementia or atherosclerotic vascular disease. Fasting serum lipids were obtained in all 200 patients. An elevated serum low-density lipoprotein (LDL) cholesterol was considered >=100 mg/dl (20). A decreased high-density lipoprotein (HDL) cholesterol was considered <40 mg/dL (20). An elevated serum triglycerides was considered >=200 mg/dl (20).

Pair-wise comparisons were made using Student's t tests for continuous variables and chi-square tests for dichotomous variables. Analysis of variance tests were used for comparison of continuous variables among the 4 groups.


   RESULTS
Top
 Abstract
 Methods
 Results
Discussion
 References
 
Table 1 shows the prevalence of women and of men, the mean age, and the prevalence of increased serum LDL cholesterol, decreased serum HDL cholesterol, and increased serum triglycerides in 50 patients with atherosclerotic vascular disease plus dementia, in 50 patients with atherosclerotic vascular disease without dementia, in 50 patients with dementia without atherosclerotic vascular disease, and in 50 patients with no dementia or atherosclerotic vascular disease. Table 1 also shows levels of statistical significance.


View this table:
[in this window]
[in a new window]
  		Table 1. Prevalence of Women and Men, Mean Age, and Prevalence of Increased Serum Low-Density Lipoprotein Cholesterol, Decreased Serum High-Density Lipoprotein Cholesterol, and Increased Serum Triglycerides in Elderly Patients With Atherosclerotic Vascular Disease Plus Dementia, Atherosclerotic Vascular Disease Without Dementia, Dementia Without Atherosclerotic Vascular Disease, and No Dementia or Atherosclerotic Vascular Disease.

 

   DISCUSSION
Top
 Abstract
 Methods
 Results
 Discussion
References
 
Dyslipidemia is present in elderly patients with atherosclerotic vascular disease (1–13). In the present study, elderly patients with atherosclerotic vascular disease with and without dementia had a significantly higher prevalence of increased levels of serum LDL cholesterol and of decreased serum HDL cholesterol than in elderly patients with no atherosclerotic vascular disease or dementia.

Observational data have also demonstrated that the use of statins was associated with a lower prevalence of vascular dementia and of Alzheimer's disease (14–16). Serum lipids were also similar in patients with Alzheimer's disease with and without cardiovascular disease (17). However, prospective, randomized, double-blind, placebo-controlled trials need to be performed to investigate the effect of statins on the development and progression of vascular dementia and of Alzheimer's disease.

In the present study, the prevalence of increased serum LDL cholesterol and of decreased serum HDL cholesterol was similar in elderly patients with atherosclerotic vascular disease plus dementia, in elderly patients with atherosclerotic vascular disease without dementia, and in elderly patients with dementia without atherosclerotic vascular disease and was significantly higher than in elderly patients with no dementia or atherosclerotic vascular disease.


   Acknowledgments
 
Address correspondence to Wilbert S. Aronow, MD, FGSA, Cardiology Division, New York Medical College, 23 Pebble Way, New Rochelle, NY 10804. E-mail: wsaronow{at}aol.com

Received December 12, 2002

Accepted December 13, 2002


   REFERENCES
Top
 Abstract
 Methods
 Results
 Discussion
 References
 

  1. Castelli WP, Wilson PWF, Levy D, Anderson K. Cardiovascular disease in the elderly. Am J Cardiol.. 1989;63:12H-19H.[Medline]
  2. Aronow WS, Ahn C. Risk factors for new coronary events in a large cohort of very elderly patients with and without coronary artery disease. Am J Cardiol.. 1996;77:864-866.[Medline]
  3. Pedersen TR, Kjekshus J, Pyorala K, et al. Effect of simvastatin on ischemic signs and symptoms in the Scandinavian Simvastatin Survival Study (4S). Am J Cardiol.. 1998;81:333-336.[Medline]
  4. Plehn JF, Davis BR, Sacks FM, et al. Reduction of stroke incidence after myocardial infarction with pravastatin. The Cholesterol and Recurrent Events (CARE) Study. Circulation.. 1999;99:216-223.[Abstract/Free Full Text]
  5. The Long-Term Intervention With Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med.. 1998;339:1349-1357.[Abstract/Free Full Text]
  6. Aronow WS, Ahn C. Correlation of serum lipids with the presence or absence of atherothrombotic brain infarction and peripheral arterial disease in 1,834 men and women aged >=62 years. Am J Cardiol.. 1994;73:995-997.[Medline]
  7. Aronow WS, Ahn C, Schoenfeld MR. Risk factors for extracranial internal or common carotid arterial disease in elderly patients. Am J Cardiol.. 1993;71:1479-1481.[Medline]
  8. Aronow WS. Treatment of older persons with hypercholesterolemia with and without cardiovascular disease. J Gerontol Med Sci.. 2001;56A:M138-M145.[Abstract/Free Full Text]
  9. Aronow WS. Should hypercholesterolemia in older persons be treated to reduce cardiovascular events? J Gerontol Med Sci.. 2002;57A:M411-M413.[Free Full Text]
  10. Aronow WS, Ahn C. Incidence of new coronary events in older persons with prior myocardial infarction and serum low-density lipoprotein cholesterol >=125 mg/dL treated with statins versus no lipid-lowering drug. Am J Cardiol.. 2002;89:67-69.[Medline]
  11. Aronow WS, Ahn C, Gutstein H. Incidence of new atherothrombotic brain infarction in older persons with prior myocardial infarction and serum low-density lipoprotein cholesterol >=125 mg/dL treated with statins versus no lipid-lowering drug. J Gerontol Med Sci.. 2002;57A:M333-M335.[Abstract/Free Full Text]
  12. Aronow WS, Ahn C. Frequency of new coronary events in older persons with peripheral arterial disease and serum low-density lipoprotein cholesterol >=125 mg/dl treated with statins versus no lipid-lowering drug. Am J Cardiol.. 2002;90:789-791.[Medline]
  13. Aronow WS, Ahn C, Gutstein H. Reduction of new coronary events and of new atherothrombotic brain infarction in older persons with diabetes mellitus, prior myocardial infarction, and serum low-density lipoprotein cholesterol >=125 mg/dl treated with statins. J Gerontol Med Sci.. 2002;57A:M747-M750.[Abstract/Free Full Text]
  14. Wolozin B, Kellman W, Rousseau P, Celesia GG, Siegel G. Decreased prevalence of Alzheimer's disease associated with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Arch Neurol.. 2000;57:1439-1443.[Abstract/Free Full Text]
  15. Jick H, Zornberg GL, Jick SS, Seshadri S, Drachman DA. Statins and the risk of dementia. Lancet.. 2000;356:1627-1631.[Medline]
  16. Hazzar I, Schumpert J, Hirth V, Wieland D, Eleazer GP. The impact of the use of statins on the prevalence of dementia and the progression of cognitive impairment. J Gerontol Med Sci.. 2002;57A:M414-M418.[Abstract/Free Full Text]
  17. Adunsky A, Chesnin V, Davidson M, Gerber LY, Alexander K, Haratz D. A cross-sectional study of lipids and ApoC levels in Alzheimer's patients with and without cardiovascular disease. J Gerontol Med Sci.. 2002:;57A:M757-M761.[Abstract/Free Full Text]
  18. Aronow WS, Ahn C, Gutstein H. Prevalence and incidence of cardiovascular disease in 1160 older men and 2464 older women in a long-term health care facility. J Gerontol Med Sci.. 2002;57A:M45-M46.[Abstract/Free Full Text]
  19. Folstein M, Folstein SE, McHugh PR. "Mini-Mental State." A practical method of grading the cognitive state of patients for the clinician. J Psychiatr Res.. 1975;12:189-198.[Medline]
  20. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) JAMA.. 2001;285:2486-2497.[Free Full Text]



This article has been cited by other articles:


Home page
 NeurologyHome page
J. A. Luchsinger, C. Reitz, L. S. Honig, M. X. Tang, S. Shea, and R. Mayeux
Aggregation of vascular risk factors and risk of incident Alzheimer disease
Neurology, August 23, 2005; 65(4): 545 - 551.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Suryadevara, V.
Right arrow Articles by Ahn, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Suryadevara, V.
Right arrow Articles by Ahn, C.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
All GSA journals The Gerontologist
Journals of Gerontology Series B: Psychological Sciences and Social Sciences