High HDL-C arrests cognitive decline in older diabetics

Yue Sun, at Department of Medicine and Therapeutics, the Chinese University of Hong Kong, and colleagues conducted the study to elucidate clinical predictors for cognitive decline in older people with diabetes mellitus (DM). They have found that in older patients with DM, higher serum high-density lipoprotein cholesterol (HDL C) is associated with a better executive function, according to a new study published in Journal of Diabetes Investigation. The results of the study imply that High HDL C arrests the cognitive decline in older diabetics.

High-density lipoproteins (HDL) are a heterogeneous group of lipoproteins composed of various lipids and proteins. HDL is formed both in the systemic circulation and in the brain. It has been firmly established that high plasma levels of HDL protect against cardiovascular disease. Accumulating evidence indicates that the beneficial role of HDL extends to many other systems including the central nervous system.

Cognition is a complex brain function that includes all aspects of perception, thought, and memory. Cognitive function often declines during aging and this decline manifests as cognitive impairment/dementia in age-related and progressive neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. A growing concern is that no effective therapy is currently available to prevent or treat these devastating diseases.

For the study, the researchers conducted a secondary analysis of a vitamin B12 intervention trial involving 271 non-demented older people with DM. They sought to assess the association between baseline clinical features and changes in cognitive measures over 27 months.

Key Findings

• At baseline, 152 subjects were cognitively normal and 119 were cognitively impaired.


• Over the study period, 41 subjects had cognitive decline, 36 of whom were cognitively normal at baseline.


• There was no significant clinical predictor of global cognitive decline.


• Higher HDL-C was associated with better executive performance at follow-up.


• In multilevel modeling, the highest tertile of HDL-C was shown to be associated with better executive function z scores than the lowest tertile of HDL-C, at all time points.

"In summary, no significant clinical factor for cognitive decline in older people with DM was found in this study," the authors write. "Higher serum HDL-C levels were associated with better performance in executive function. Elucidation of the underlying mechanisms of this association may lead to effective prevention strategies to prevent cognitive decline in older people with DM, conclude the authors."

For more information log on to https://doi.org/10.1111/jdi.12865