Cholesterol-lowering drugs can also protect the brain: How statins and genes prevent dementia

Lowering high cholesterol could protect both the heart and the brain, lowering the risk of dementia, according to a meta-analysis that included nearly 1 million participants.

Cholesterol-lowering drugs, like certain foods, can also protect the brain Collage DMS

The results, published in the prestigious scientific journal Alzheimer's & Dementiasuggests that commonly used cholesterol-lowering drugs—such as statins and ezetimibe—may also have beneficial effects on cognitive health.

Next, readers will learn how genes influence cholesterol and dementia risk, what role atherosclerosis plays in brain damage, and what perspectives clinical trials open for the prevention of this neurodegenerative disease.

LDL cholesterol and risk of dementia: new evidence from a large study

The study, conducted by researchers from the University of Bristol (UK) and Copenhagen University Hospital (Denmark), builds on previous research that linked cholesterol “river” (low-density lipoproteins – LDL-C) with the onset of dementia. It's not a new idea, but this analysis provides one of the most detailed data sets and strongest evidence yet for this link, and suggests that treatments could address both issues simultaneously.

“Current data indicate that cholesterol reduction earlier in life might diminish risk of dementia later”the authors write in the published article.

Cholesterol-lowering genes may lower dementia risk

The study did not follow people taking cholesterol medication, but used genetic variants associated with lower cholesterol levels as a proxy for a lifetime of statin treatment – ​​a method known as Mendelian randomization.

A key advantage of comparing genes is that this method eliminates the influence of factors that are difficult to measure precisely, such as diet or level of physical activity.

Mendelian randomization: the method linking cholesterol to brain health

The research team found a significant correlation between a genetic predisposition to low cholesterol and a reduced risk of dementia, suggesting that biological mechanisms influenced by genes that keep cholesterol low – the same mechanisms targeted by statins and ezetimibe – may also influence the likelihood of dementia.

“What our study shows is that people who have these cholesterol-lowering genetic variants seem to have a significantly lower risk of developing dementia,” said Liv Tybjærg Nordestgaard, a clinical biochemist who was part of the team at the University of Bristol during the research.

Atherosclerosis and its role in the development of dementia

By using the Mendelian randomization method, combined with an extensive data set, the researchers were able to show with a high degree of certainty that genetically determined lower cholesterol levels are most likely the reason why some people have a lower risk of dementia.

The study authors suggest that atherosclerosis – the accumulation of fatty deposits of cholesterol in blood vessels – may be a key element of the disease mechanism. This process can lead to brain damage, and some forms of dementia are known to be caused by problems with insufficient blood flow to the brain.

Lowering cholesterol: a promising strategy for dementia prevention

The researchers hope to conduct future clinical trials in which cholesterol-lowering drugs are administered directly to participants to see if the protective effects on the brain hold up in practice.

“It would be a natural and extremely valuable step to conduct randomized clinical trials over a period of 10 to 30 years, for example, in which participants are given drugs that lower cholesteroland then the risk of developing dementia is analyzed”, explains Liv Tybjærg Nordestgaard.

If these clinical trials confirm the protective effects of cholesterol-lowering drugs, they could pave the way for effective strategies to prevent dementia and maintain long-term brain health. The results could provide strong evidence for the use of statins and other lipid-lowering treatments not only to protect the heart, but also to reduce the risk of dementia, underscoring the importance of cholesterol monitoring in the prevention of neurodegenerative diseases.