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A new study has revealed that the risk of Alzheimer’s disease in women may be influenced by the quality, rather than the quantity, of high-density lipoprotein cholesterol (HDL-C), commonly known as “good” cholesterol. Researchers at the University of Pittsburgh, USA, have found that while higher levels of HDL-C are generally considered beneficial for heart health, their impact on brain health—particularly in relation to Alzheimer’s disease—depends on the functional quality of the HDL particles circulating in the blood.
Published in the Journal of Clinical Endocrinology and Metabolism, the study focuses on the menopausal transition in women and its effect on HDL particles. As women age, especially around midlife, the number of larger HDL particles in their bodies increases. However, these larger particles are not as effective in maintaining brain health as their smaller counterparts. It is the smaller-sized HDL particles, which are rich in phospholipids, that play a critical role in protecting cognitive function.
Dr. Samar R. El Khoudary, professor of epidemiology at Pitt Public Health and lead author of the study, explains, “We were able to show that as early as midlife, women who have more of the smaller-sized particles and whose particles’ concentrations of phospholipids increased over the menopause transition are more likely to experience better episodic memory later in life.”
The research emphasizes that the loss of episodic memory—the ability to recall specific events or experiences—is one of the earliest signs of Alzheimer’s disease. This study presents an important shift in how medical professionals understand the role of HDL cholesterol in cognitive health, particularly in women. While HDL particles vary in size, composition, and function, this study highlights the importance of their quality, especially during menopause, when changes in hormone levels affect cholesterol metabolism.
The study, which ran from 2000 to 2016, involved repeated cognitive assessments of female participants. The researchers tracked changes in the composition and function of HDL particles over time, correlating these findings with cognitive performance. The results showed that participants with higher levels of smaller, phospholipid-rich HDL particles had better memory retention and cognitive outcomes later in life.
The researchers also noted that health behaviors such as exercise, a balanced diet, and avoiding smoking can help improve the quality of HDL particles. “That’s the good news in this developing picture of brain health and the ‘not-so-good-after-all’ cholesterol,” El Khoudary added, emphasizing the importance of lifestyle factors that can influence HDL particle composition.
Despite the findings that higher levels of HDL-C alone may not be as protective against Alzheimer’s in later life, the study offers hope. Women in their 40s and beyond can potentially improve their HDL particle quality through positive lifestyle changes, which may help maintain cognitive health as they age.
This groundbreaking research sheds new light on the complex relationship between cholesterol and brain health, particularly for women, and opens up potential avenues for early interventions aimed at preventing Alzheimer’s disease.
