Abstract
The association between dyslipidemia and cognitive performance in Parkinson’s disease (PD) patients still needs to be clarified. Aim of the study was to evaluate the presence of possible associations between serum lipids fractions and executive dysfunction also exploring the sex-specific contribute of lipids level on cognition. Patients from the PACOS cohort, who underwent a complete serum lipid profile measures (total cholesterol-TC, low-density lipoprotein cholesterol-LDL, high-density lipoprotein cholesterol-HDL and triglycerides-TG) were selected. Adult Treatment Panel III guidelines of the National Cholesterol Education Program were used to classify normal/abnormal lipid fractions. Executive functioning was assessed with the Frontal Assessment Battery (FAB). Logistic regression was performed to assess associations between lipids fractions and FAB score. Correlations between lipids fractions and FAB score were explored. Sex-stratified analysis was performed. Three hundred and forty-eight PD patients (148 women; age 66.5 ± 9.5 years; disease duration 3.9 ± 4.9 years) were enrolled. Women presented significantly higher TC, LDL and HDL than men. In the whole sample, any association between lipid profile measures and FAB score was found. Among women, a positive association between hypertriglyceridemia and FAB score under cutoff was found (OR 3.4; 95%CI 1.29–9.03; p value 0.013). A statistically significant negative correlation was found between the FAB score and triglyceride serum levels (r = − 0.226; p value 0.005). Differently, among men, a statistically significant negative association between hypercholesterolemia and FAB score under cutoff (OR 0.4; 95%CI 0.17–0.84; p value 0.018) and between high LDL levels and FAB score under cutoff (OR 0.4; 95%CI 0.18–0.90; p value 0.027) were found. Our data suggest a sex-specific different role of lipids in executive functioning.
Highlights
In Parkinson’s disease (PD) cognitive decline is mainly characterized by executive dysfunction, set of cognitive abilities including planning, monitoring, set-shifting, inhibiting behaviors and manipulating information (Fang et al 2020).Interestingly, an increasing literature evidence suggests relevant sex-differences in the clinical presentation of cognitive impairment in PD
At both univariate analysis and multivariate analysis, no statistically significant association was found between serum lipid fractions (TG, total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL)) and Frontal Assessment Battery (FAB) score (Table 2)
Sex-specific differences in serum lipid profile have been frequently reported in healthy aged individuals and associated with worse cognitive performance (Lu et al 2017)
Summary
In Parkinson’s disease (PD) cognitive decline is mainly characterized by executive dysfunction, set of cognitive abilities including planning, monitoring, set-shifting, inhibiting behaviors and manipulating information (Fang et al 2020).Interestingly, an increasing literature evidence suggests relevant sex-differences in the clinical presentation of cognitive impairment in PD. Several modifiable risk factors have been associated with cognitive decline in PD patients, including systolic blood pressure, diabetes, smoking, decreased physical activity, obesity and dyslipidemia (Nicoletti et al 2021; Guo et al 2019). Considering the devastating effects of cognitive impairment on the patient’s quality of life and their family caregivers’ well-being, the identification of possibly modifiable risk factors is undoubtedly useful. Concerning dyslipidemia, while several studies have investigated the possible link between altered serum lipid profile measures and cognitive decline both in patients with Alzheimer’s disease (Bernath et al 2020; Sàiz-Vazquez et al 2020) and in non-demented elderly (Parthasarathy et al 2017), the role of serum lipids in PD is quite controversial. Most of the existing studies did not consider the sex-specific differences when evaluating possible associations between lipids levels and cognition
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