“Good” cholesterol may increase the risk of dementia

A recent study has revealed a surprising twist in the narrative about “good” cholesterol, HDL (High-density lipoprotein). 

Contrary to its long-held reputation for cardiovascular benefits, high levels of HDL are now linked with an increased risk of dementia, including Alzheimer’s disease.

Good vs. bad cholesterol 

Traditionally, HDL has been celebrated for its role in cardiovascular health. It absorbs cholesterol from the blood and transports it to the liver for removal, which is why it’s been deemed “good.” 

Low-density lipoprotein, the so-called “bad” cholesterol, is known for transporting cholesterol particles throughout the body, contributing to the build-up of plaque in arteries, a leading cause of heart disease and stroke.

Focus of the study

However, the findings from a study published in the journal Lancet Regional Health – Western Pacific suggest a complex relationship between high-density lipoprotein and brain health. 

The study involved tracking over 18,600 individuals aged 65 and above for six years, during which 4.6 percent of participants developed dementia. 

Key findings

Surprisingly, those with very high HDL levels faced a 27 percent increased risk of dementia, with the risk spiking to 42 percent in individuals aged 75 and older.

The research team from Australia clarified that these increased risks were independent of other traditional dementia risk factors such as physical activity, education, diabetes, smoking, or alcohol consumption. 

The experts defined “very high” levels of HDL as 80 mg/dL or higher, a rarity in the study and not typically associated with dietary factors but possibly indicative of underlying metabolic disorders. The correlation between high HDL levels and increased dementia risk echoes the findings of a study from 2022. 

Further research is needed 

Dr. Monira Hussain, the first author and a senior research fellow at Monash University‘s School of Public Health and Preventive Medicine, emphasized the need for further research to understand this phenomenon. 

“While we know HDL cholesterol is important for cardiovascular health, this study suggests that we need further research to understand the role of very high HDL cholesterol in the context of brain health.”

Broader implications 

The study’s implications extend beyond the scientific community to potentially impact medical practice. The ease of measuring cholesterol levels and the possibility of influencing them through lifestyle changes position cholesterol as a potential biomarker for dementia risk.

Currently, approximately 5.8 million Americans are living with Alzheimer’s disease, the most common form of dementia, primarily affecting those over 65. This number is projected to nearly double by 2050. The exact cause of Alzheimer’s remains a subject of debate, but abnormal protein build-ups in the brain are believed to play a significant role.

“What we are learning now is that there is a lot more nuance to HDL’s role in the body. As a result, I usually explain to patients that it is more ‘neutral’ than ‘good,'” said cardiologist Corey Bradley. This statement underscores the complexity of cholesterol’s impact on the body, signaling a shift in how medical professionals may approach cholesterol management in the context of overall health.

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