High cholesterol linked to MS cognitive impairment in study
Researchers say lifestyle changes, cholesterol medication may help
Higher cholesterol levels are associated with worse cognitive impairments in people with multiple sclerosis (MS), a study reported.
The findings imply that medications or lifestyle changes that reduce cholesterol levels may be useful for addressing MS cognitive impairment, researchers said.
The study, “Lipid measures are associated with cognitive functioning in multiple sclerosis patients,” was published in Multiple Sclerosis and Related Disorders.
Cholesterol is a lipid (fat molecule) that plays many important roles in human health. There are two main types of cholesterol in the body: HDL and LDL cholesterol. HDL is sometimes called good cholesterol because higher levels of it are associated with reduced risk of heart disease, whereas LDL cholesterol is referred to as bad, because high LDL levels are linked with cardiovascular problems.
Cognitive impairments, such as problems with memory and language, are a common MS symptom that can be difficult to manage. Some studies have suggested that abnormalities in lipid metabolism are connected to MS-related cognitive impairment, but this research is still in early stages.
MS and cognitive impairment
To further explore the potential connection, a team led by researchers in the Czech Republic analyzed levels of lipids, particularly cholesterol, in 211 people with MS. All underwent a battery of cognitive tests within three months of having their lipid levels measured, and because some patients underwent lipid and cognitive testing more than once, a total of 361 timepoints were assessed.
While there is “growing evidence suggesting a link between [cholesterol levels] with cognitive outcomes of patients, this evidence is derived from a limited number of cross-sectional studies with high risk of bias and with using of different cognitive assessment scales and methods,” the scientists wrote. “Therefore, the main aim of this study was to investigate the association between adverse lipid profiles and cognitive performance using postandardized cognitive scales in a large sample of patients with MS.”
Results showed that higher cholesterol levels were significantly correlated with poorer performance on some cognitive measures.
Specifically, higher levels of LDL cholesterol were associated with worse scores on the Categorical Verbal Learning Test (CVLT), a measure of word-based learning, and lower scores on a memory test called the Brief Visuospatial Memory Test-Revised (BVMT-R). Meanwhile, higher HDL cholesterol was linked with worse scores on a measure of auditory processing and mathematical ability called the Paced Auditory Serial Addition Test-3 (PASAT-3).
Although these associations between cholesterol levels and cognitive scores were statistically significant, the researchers stressed that the extent of the correlations was quite modest. In statistical models, even the strongest associations suggested that cholesterol levels explained less than 6% of the variation in cognitive scores.
“Our study confirms the association between adverse lipid profile and worse cognitive performance in [people with] MS,” they wrote. “However, the degree of pathophysiological relevance was small, as the lipid measures explained only 1.4 % to 5.8 % of the variance in cognitive performance.”
Still, the researchers noted, lifestyle modifications and medications can be used to alter cholesterol levels. Given the potential link between cholesterol and cognition, they proposed that interventions to reduce cholesterol levels might be explored as potential strategies to help manage cognitive problems in MS.
“Given that serum lipids levels may be influenced not only by lifestyle interventions, but also by medication further research in this area may have an important clinical relevance,” the team wrote.
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