Abstract P008: Atherogenic Cholesterol Across The Lifespan And The Relationship With Midlife Global Cognitive Function: The Bogalusa Heart Study

Abstract

Background: Higher levels of non-atherogenic cholesterol (HDL) may be protective against vascular risk and inflammation, mechanisms accompanying cognitive impairment in late life. However, the role of atherogenic lipoproteins remains controversial. Evidence suggests that CV risk burden in middle age may be more closely associated with late-life brain health. Therefore, we aimed to explore the relationship between atherogenic cholesterol (non-HDL) in a community-based cohort of midlife adults. Methods: A total of 1,266 adult participants (58.9% Woman, 34.5% African American) from the Bogalusa Heart Study, with cognitive function assessment at age 48 ± 5 years and at least 3 observations of lipoproteins since childhood. A standardized global cognitive score (GCS) was obtained from a battery of tests covering major neuropsychological domains. Non-HDL trajectories were created using latent class trajectory modeling. Linear regression models were used to determine the association between non-HDL trajectories and GCS in midlife. Results: The mean follow-up for non-HDL and other traditional cardiovascular (CV) risk factors was 41.8 ± 3.4 years. Four distinct trajectory classes were identified: class 1 (n= 451 [ 36%]), class 2(n=168 [13.2%]), class 3 (n=530 [41.8%]), and class 4 (n=117 [9 %] (Figure 1). With class 1 as reference, and after adjustment for sex, race, education, cholesterol medication, hypertension, and diabetes comorbidities. Class 2 and class 4 trajectories were associated with lower GCS (Beta= -0.65 [SE 0.28]; p =0.022, and Beta = -0.06 [0.31]; p=0.057, respectively). (Table 1) Conclusions: These findings suggest that highly-increasing atherogenic cholesterol trajectories over time, particularly from early adulthood to middle age, may adversely affect cognitive performance in midlife, independent of other dementia risk factors. This underscores the importance of addressing CV risk factors earlier in the life course, as their cumulative burden could have a detrimental impact on brain health.