The association of cholesterol levels with memory and memory change over a 14-year period in a US national cohort.

Introduction: The impact of cholesterol on late-life cognition remains controversial. We investigated the association of high-density lipoprotein cholesterol (HDL-C) and non-HDL-C with memory in a nationally representative cohort.
Methods: Health and Retirement Study (HRS) participants ( N  = 13,258) aged 50+ (mean age: 67.2 years) followed from 2006 to 2020 provided cholesterol measures every 4 years and cognitive assessments biennially. Linear mixed models predicted memory scores using both baseline and time-updated cholesterol values.
Results: Higher baseline HDL-C (mean: 53.9 mg/dL) predicted better memory scores ( β : 0.05, 95% confidence interval [CI]: 0.03 to 0.08), but not memory change. Baseline non-HDL-C (mean: 143 mg/dL) predicted poorer memory scores ( β : -0.01, 95% CI: -0.02 to 0.00), but not memory change. Time-updated HDL-C predicted better memory ( β : 0.02, 95% CI: 0.00 to 0.04), but non-HDL-C showed no such associations.
Discussion: While higher peripheral HDL-C is linked to better memory, the small effect sizes and absence of associations of HDL-C and non-HD-CL with memory change suggests that peripheral cholesterol has a small effect on the variation of memory scores.
Highlights: Higher HDL-C levels predict better memory scores but not memory change across 14 years of follow-up.Baseline higher LDL-C levels predict poorer memory scores across time, but not memory change.The small effects and absence of consistent association between cholesterol levels and memory change suggest that cholesterol plays a minor role in cognitive decline.
Competing Interests: The authors report no relevant conflicts of interest or disclosures. Author disclosures are available in the Supporting Information.
(© 2025 The Author(s). Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)