It has been suggested that higher triglyceride levels were associated with a lower risk of Alzheimer disease. This study aimed to examine the association of triglycerides with dementia and cognition change in community-dwelling older adults.

This prospective longitudinal study used data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized trial of adults aged 65 years or older without dementia or previous cardiovascular events at enrollment. The main outcome was incident dementia. Other outcomes included changes in composite cognition and domain-specific cognition (global cognition, memory, language and executive function, and psychomotor speed). The association between baseline triglycerides and dementia risk was estimated using Cox proportional hazard models adjusting for relevant risk factors. Linear mixed models were used to investigate cognitive change. The analysis was repeated in a subcohort of participants with available APOE-4 genetic data with additional adjustment for APOE-4 carrier status and an external cohort (UK Biobank) with similar selection criteria applied.

This study included 18,294 ASPREE participants and 68,200 UK Biobank participants (mean age: 75.1 and 66.9 years; female: 56.3% and 52.7%; median [interquartile range] triglyceride: 106 [80–142] mg/dL and 139 [101–193] mg/dL), with dementia recorded in 823 and 2,778 individuals over a median follow-up of 6.4 and 12.5 years, respectively. Higher triglyceride levels were associated with lower dementia risk in the entire ASPREE cohort (hazard ratio [HR] with doubling of triglyceride: 0.82, 95% CI 0.72–0.94). Findings were similar in the subcohort of participants with APOE-4 genetic data (n = 13,976) and in the UK Biobank cohort (HR was 0.82 and 0.83, respectively, all p ≤ 0.01). Higher triglycerides were also associated with slower decline in composite cognition and memory over time (p ≤ 0.05).

Older adults with higher triglyceride levels within the normal to high-normal range had a lower dementia risk and slower cognitive decline over time compared with individuals with lower triglyceride levels. Higher triglyceride levels may be reflective of better overall health and/or lifestyle behaviors that would protect against dementia development. Future studies are warranted to investigate whether specific components within the total circulating pool of plasma triglycerides may promote better cognitive function, with the hope of informing the development of new preventive strategies.

有人认为，较高的甘油三酯水平与较低的阿尔茨海默病风险相关。本研究旨在探讨甘油三酯与社区老年人痴呆和认知变化的关系。

这项前瞻性纵向研究使用了阿司匹林减少老年人事件 (ASPREE) 随机试验的数据，试验对象为 65 岁或以上、入组时没有痴呆或既往心血管事件的成年人。主要结果是痴呆症。其他结果包括复合认知和特定领域认知（整体认知、记忆、语言和执行功能以及精神运动速度）的变化。使用调整相关风险因素的 Cox 比例风险模型来估计基线甘油三酯和痴呆风险之间的关联。线性混合模型用于研究认知变化。在具有可用APOE -4 遗传数据的参与者子队列中重复进行分析，并对APOE -4 携带者状态进行额外调整，并在应用类似选择标准的外部队列（英国生物库）中重复进行分析。

这项研究包括 18,294 名 ASPREE 参与者和 68,200 名英国生物银行参与者（平均年龄：75.1 和 66.9 岁；女性：56.3% 和 52.7%；中位[四分位距]甘油三酯：106 [80–142] mg/dL 和 139 [101–193] mg/dL ] mg/dL），在中位随访时间为 6.4 年和 12.5 年期间，分别有 823 人和 2,778 人记录了痴呆症。在整个 ASPREE 队列中，较高的甘油三酯水平与较低的痴呆风险相关（甘油三酯加倍的风险比 [HR]：0.82，95% CI 0.72-0.94）。具有 APOE-4 遗传数据的参与者子队列 (n = 13,976) 和英国生物银行队列 (HR 分别为 0.82 和 0.83，所有p ≤ 0.01)的结果相似。随着时间的推移，较高的甘油三酯还与复合认知和记忆力下降较慢相关（p≤0.05）。

与甘油三酯水平较低的人相比，甘油三酯水平在正常至高正常范围内的老年人患痴呆症的风险较低，认知能力随时间下降的速度也较慢。较高的甘油三酯水平可能反映了更好的整体健康和/或生活方式行为，可以预防痴呆症的发展。未来的研究有必要调查血浆甘油三酯总循环池中的特定成分是否可以促进更好的认知功能，希望为新的预防策略的开发提供信息。