{
  "abstract": "Background The link between low-density lipoprotein cholesterol (LDL-C) levels and dementia risk is poorly understood, with conflicting evidence on the role of LDL-C and the impact of statin therapy on cognitive outcomes. Thus, we aimed to examine the association between low-density LDL-C levels and the risk of dementia and assess the influence of statin therapy.Methods We retrospectively analysed data from 11 university hospitals participating in the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). Participants with a prior diagnosis of dementia or those with <180 days of observation before cohort inclusion, and those included in both cohorts were excluded. The primary outcome was all-cause dementia, with the secondary outcome being Alzheimer’s disease-related dementia (ADRD). The study utilised 1:1 propensity score matching to compare individuals with LDL-C levels below 70 mg/dL (1.8 mmol/L) against those with levels above 130 mg/dL (3.4 mmol/L), resulting in a primary analysis cohort of 108 980 matched patients. Secondary analyses further examined LDL-C thresholds below 55 mg/dL (1.4 mmol/L) and the influence of statin use.Results The LDL-C levels below 70 mg/dL (1.8 mmol/L) were associated with a 26% reduction in the risk of all-cause dementia and a 28% reduction in the risk of ADRD, compared with levels above 130 mg/dL (3.4 mmol/L). For LDL-C levels below 55 mg/dL (1.4 mmol/L), there was an 18% risk reduction for both outcomes. Among those with LDL-C <70 mg/dL (<1.8 mmol/L), statin use was associated with a 13% reduction in all-cause dementia risk and a 12% decrease in ADRD risk compared with non-users.Conclusion Low LDL-C levels (<70 mg/dL (<1.8 mmol/L)) are significantly associated with a reduced risk of dementia, including ADRD, with statin therapy providing additional protective effects. These findings support the necessity of targeted lipid management as a preventive strategy against dementia, indicating the importance of personalised treatment approaches.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea (the Republic of)"
      ],
      "name": "Minwoo Lee"
    },
    {
      "affiliations": [
        "Department of Medical Informatics & Statistics, Kangdong Sacred Heart Hospital, Seoul, Korea (the Republic of)"
      ],
      "name": "Kyung Joo Lee"
    },
    {
      "affiliations": [
        "Zarathu Co Ltd, Seoul, Korea (the Republic of)"
      ],
      "name": "Jinseob Kim"
    },
    {
      "affiliations": [
        "Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea (the Republic of)",
        "Bongdam forest mental health clinic, Hwaseong, Korea (the Republic of)"
      ],
      "name": "Dong Yun Lee"
    },
    {
      "affiliations": [
        "Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea (the Republic of)"
      ],
      "name": "Rae Woong Park"
    },
    {
      "affiliations": [
        "Department of Digital Health and Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Sang Youl Rhee"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Jae Myung Cha"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Hyeon-Jong Yang"
    },
    {
      "affiliations": [
        "Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea (the Republic of)"
      ],
      "name": "Jae-Won Jang"
    },
    {
      "affiliations": [
        "Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Korea (the Republic of)"
      ],
      "name": "Seunguk Jung"
    },
    {
      "affiliations": [
        "Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea (the Republic of)"
      ],
      "name": "Jeeun Lee"
    },
    {
      "affiliations": [
        "Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea (the Republic of)"
      ],
      "name": "Sang-Hwa Lee"
    },
    {
      "affiliations": [
        "Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea (the Republic of)"
      ],
      "name": "Chulho Kim"
    },
    {
      "affiliations": [
        "Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Jong-Seok Bae"
    },
    {
      "affiliations": [
        "Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Yeo Jin Kim"
    },
    {
      "affiliations": [
        "Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Ju-Hun Lee"
    },
    {
      "affiliations": [
        "Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Hyoeun Bae"
    },
    {
      "affiliations": [
        "Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of)"
      ],
      "name": "Yerim Kim"
    }
  ],
  "title": "Low-density lipoprotein cholesterol levels and risk of incident dementia: a distributed network analysis using common data models",
  "uid": "8fdcd3b5-3773-5623-b604-6f09c1fbc2ca"
}