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New large-scale research suggests that lowering cholesterol may do more than protect the heart. A comprehensive genetic analysis indicates that lifelong lower levels of LDL cholesterol are linked with a reduced risk of developing dementia, implying that common cholesterol medicines could have cognitive benefits too.
How researchers reached this connection
Investigators from the University of Bristol and Copenhagen University Hospital pooled genetic and health data across studies that together numbered nearly a million participants. Rather than tracking who took statins or other drugs, the team used a Mendelian Randomization approach. This method treats naturally occurring genetic variants that lower LDL cholesterol as a stand-in for a lifelong exposure to lower cholesterol.
Why Mendelian Randomization matters
By comparing people based on their inherited variants, the method reduces confounding from lifestyle factors such as diet, exercise, and socioeconomic status. If people with genetic variants that lower cholesterol also have lower dementia rates, that strengthens the case for a causal relationship between cholesterol and cognitive decline.
Key findings and biological clues
The analysis found a consistent association: genetic predictors of lower LDL cholesterol corresponded with a noticeably lower risk of dementia. The results echo earlier observational work but add weight by using genetics to approximate the effect of long-term cholesterol reduction.
The researchers point to atherosclerosis as a likely mechanism. Fatty cholesterol deposits can narrow and stiffen blood vessels, reducing blood flow to the brain. Over years, such impaired circulation can cause brain injury and contribute to forms of dementia that are sensitive to vascular health.
Around 57 million people are living with dementia worldwide.
Implications for treatment and research
The study suggests that drugs targeting the same biological pathways as the protective genetic variants could lower dementia risk if used earlier or over long periods. Statins and ezetimibe, for example, act on pathways that influence LDL cholesterol and are the types of medications the study authors believe may confer benefit beyond cardiovascular protection.
Still, genetics is a proxy. The team welcomes randomized clinical trials that assign participants to cholesterol-lowering medication and follow cognitive outcomes over many years. Such trials would be the clearest way to test whether statins or similar drugs can actually prevent or delay dementia.
What this means for readers
For clinicians and people at risk of cardiovascular disease, the findings reinforce the connection between vascular health and the brain. It may be another reason to manage cholesterol, alongside blood pressure control, smoking cessation, and physical activity. But individuals should not begin or stop medication based on this study alone. Decisions about statins and other lipid-lowering drugs remain personal and should involve a clinician discussing risks and benefits.
The authors conclude that lowering cholesterol earlier in life could reduce the chance of dementia later on, and they call for long-term randomized trials to confirm whether cholesterol-lowering therapies protect the brain as they protect the heart.
Source: sciencealert
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