Cholesterol-modifying strategies for Alzheimer’s disease

Abstract

The link between cholesterol and Alzheimer’s disease (AD) is indicated by genetic, epidemiological, experimental and clinical evidence, although the relationship is far from simple or straightforward. Compared with extracerebral cholesterol, little is known about brain cholesterol homeostasis. In addition, current diagnostic criteria for AD exclude a priori the pathogenic participation of vascular factors (to which cholesterol is traditionally associated), and require modifications. Randomized controlled trials suggest that the dementia stage of AD may already be too late for significant benefits of statin therapy, emphasizing the importance of early diagnosis and treatment. Cholesterol-modifying strategies may be more effective in dementia/AD prevention. Since cholesterol is only one piece of the dementia/AD puzzle, integrative interventions (lifestyle-related and, when necessary, pharmacologic) focusing on overall risk instead of individual risk factors may bring more benefit to individuals at risk.

Keywords::

• Alzheimer
• cholesterol
• cognition
• dementia
• prevention
• statin
• treatment

Financial & competing interests disclosure

The authors wish to acknowledge the Academy of Finland grant 120676, EU FP7 project LipiDiDiet 211696 and EC FP6, MEST-CT-2005-019217. Miia Kivipelto serves as a steering committee member for Pfizer, served as an advisory board member for Elan, and has received honoraria for lectures from Pfizer, Novartis and Jansen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.