JCL Roundtable: Lipid metabolism, brain health, and dementia prevention

One in 10 individuals 65 years and older has dementia. The most common form is Alzheimer's disease, followed by vascular dementia. There are myriad shared risk factors between brain health and cardiovascular health, including modifiable risk factors such as high cholesterol, diabetes, hypertension, obesity, and physical inactivity. Important nonmodifiable dementia risk factors include increasing age and the apolipoprotein E4 allele, which negatively alters brain cholesterol handling and the integrity of the blood-brain barrier. This Journal of Clinical Lipidology Roundtable presents a conversation between Drs Anum Saeed, James Trippi, Priya Palta, Kellyann Niotis, and Kevin C. Maki, who discussed the heart-brain connection in health and disease, including the epidemiology of dementia, lipids, and other shared risk factors between heart and brain health, and the lipid biology related to neurodegeneration with an emphasis on apolipoprotein E alleles. They also discussed the role of cognitive testing, biomarkers, including blood biomarkers, metabolomics, and brain imaging measurements, as well as the available evidence-based strategies to reduce risk and ongoing investigations of potential future therapies. Their conversation emphasized the importance of early prevention to decrease cardiovascular and dementia risks. Prevention is not just the best strategy to reduce the risk of dementia, but is virtually the only strategy available to clinicians at this time.