Cholesterol Isn't Just About Heart Health—It May Be the Missing Link In Alzheimer's, Says New Study
A new study suggests that there's a link between how well you move cholesterol to the neurons in your brain and Alzheimer's disease.
This factor is connected to the APOE4 genetic variant, which significantly increases your risk of developing the disease.
Here's what to know and what this means for Alzheimer's research.
Alzheimer's disease sparks a cascade of changes throughout the body that lead to a slew of debilitating symptoms. But there's one surprising biological change that researchers are just starting to uncover, thanks to a new study.
The study, which was published in the Journal of Lipid Research, found that people with Alzheimer's disease experience a breakdown in the ability to shuttle cholesterol to the neurons in their brain, and that this symptom is linked to a certain genetic variant called APOE4, which carries a known risk for Alzheimer's.
This biological discovery could potentially pave the way for a better understanding of the disease and even future disease prevention methods. Here's what you need to know about the science so far, with input from a neurologist.
Meet the expert: Clifford Segil, DO, is a neurologist at Providence Saint John's Health Center in Santa Monica, CA.
What did the researchers find?
For the study, researchers analyzed the cerebrospinal fluid (the biological liquid that surrounds and cushions the brain and spinal cord) from 10 patients with Alzheimer's disease and compared it to the cerebrospinal fluid of 10 people who did not have the condition.
They discovered that lipoproteins (round particles made of fat and protein) in the cerebrospinal fluid of Alzheimer's patients were less effective at delivering cholesterol to neurons, or nerve cells, which are responsible for transmitting information from the brain throughout the body.
What is cholesterol?
Cholesterol is an essential, waxy, fat-like molecule that your body needs for good health, according to the National Heart Lung and Blood Institute (NHLBI). Cholesterol is carried around your body by two types of lipoproteins: low-density lipoproteins (a.k.a. LDL or 'bad' cholesterol) and high-density lipoproteins (a.k.a. HDL or 'good' cholesterol).
High levels of LDL cholesterol can cause a buildup of fatty deposits called plaque in your arteries, raising the risk of heart attack, stroke, and other health complications, per the NHLBI. But high levels of good HDL cholesterol may lower the risk for certain health issues.
Why is it important for brain function?
While it has a bad rap in the health world, cholesterol is actually really important for your proper brain function. Your brain is the most cholesterol-rich organ in your body. Specifically, cholesterol helps make up cell membranes, including those in nerve cells, and plays a crucial role in your neurons' ability to "talk" to each other and transmit information. When cholesterol levels are out of balance, it can impact that transmission of essential information between nerve cells, leading to cognitive issues that are seen with neurodegenerative diseases like Alzheimer's disease. Cholesterol is also a building block for steroid hormones, which support brain function.
However, that doesn't mean more cholesterol is always good for your brain. High levels of LDL cholesterol are usually considered a modifiable risk factor for ischemic stroke, or 'clogged pipes' in the brain, explains Clifford Segil, DO, a neurologist at Providence Saint John's Health Center in Santa Monica, CA.
'There is less research and understanding on the possible benefits of cholesterol found in spinal fluid including HDL, which we classically identify as the 'good cholesterol,'' Dr. Segil says. 'We know high levels of certain types of cholesterol cause strokes and we are less clear in the year 2025 about the benefits of cholesterol in brain function.'
How does this link back to Alzheimer's?
This particular study noted that cholesterol found in lipoproteins were different in patients with Alzheimer's disease, but Dr. Segil says that there is a 'complicated' relationship between lipids and protein in the brain. 'Some researchers continue to assign memory loss symptoms in patients with Alzheimer's due to abnormal brain protein levels and this paper noted lipid brain levels may also be abnormal,' he says.
Dr. Segil points out that neurologists commonly prescribe medications called statins to lower levels of cholesterol and the risk of stroke. Lowering levels of LDL cholesterol can decrease the risk of developing certain type of dementia, including vascular dementia, he says. But it's not clear if it may do more.
'Further research will determine if lowering your cholesterol will result in lower chances of getting Alzheimer's dementia,' he says.
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Thyroid Function Thyroid stimulating hormone (TSH): TSH is produced by your pituitary gland, and it's a standard screening marker that can give you a better sense of your thyroid health, says Dr. Gidwani. High TSH can indicate hypothyroidism and low TSH can indicate hyperthyroidism, per Cleveland Clinic. Free T3 and Free T4: TSH alone doesn't always give you the full picture of how well your thyroid is functioning, Dr. Gidwani says—so you should also test Free T3 and Free T4 (which indicate your active thyroid hormones) to get a fuller, more detailed picture. 'Free T3 and Free T4 are the active forms of thyroid hormone that directly affect your metabolism, energy levels, mood, and cognitive function,' Dr. Gidwani says. Your 'TSH could be normal while Free T3 is low, which might explain fatigue, brain fog, or weight changes,' she says. Reverse T3: Testing this marker can help identify hypothyroidism or stress-related suppression, Dr. Gidwani says. TPO and TG antibodies: These are early markers of autoimmune thyroid disease, per Dr. Gidwani. Micronutrient and Cellular Health Vitamin D: Optimal vitamin D levels support immune function, hormonal health, bone strength, insulin sensitivity, and even mood regulation, Dr. Gidwani says—and chronically low levels have been linked to higher risk of cardiovascular disease, autoimmune conditions, metabolic syndrome, and depression. It may even help reduce risk of dementia. Checking vitamin D levels is also recommended for people with low bone mass (osteopenia or osteoporosis) and kidney disease, says Dr. Yusupov. : This one's essential for red blood cell production and neurological health. 'Deficiency can cause fatigue, cognitive changes, and nerve symptoms like numbness, tingling, burning sensations, or even electric shock-like feelings,' says Dr. Gidwani. Checking your B12 is important for memory, energy, and it can be especially helpful for vegans (since B12 is not naturally found in plants) and people who have had weight loss surgery (who may be more susceptible to deficiency), she says. Folate: Also known as vitamin B9, folate works with vitamin B12 and is another marker that plays a role in reducing cardiovascular risk. Methylmalonic acid (MMA): Even if your vitamin B12 levels are normal, it doesn't always reflect whether your cells are able to use it. A methylmalonic acid (MMA) test, which indirectly measures how well vitamin B12 is working in the body, can help catch deficiency early. 'That's why MMA is especially helpful when symptoms are present but standard B12 levels look fine,' Dr. Gidwani says. Magnesium: It supports enzymes involved in metabolism, blood sugar regulation, muscle function, and sleep, Dr. Gidwani says. More daily magnesium has also been linked to lower dementia risk. 'Deficiency can contribute to fatigue, insulin resistance, headaches, and anxiety, yet it's often missed in routine bloodwork,' she adds. index: This biomarker is 'strongly predictive of cardiovascular and cognitive health,' says Dr. Gidwani. Low levels are associated with chronic inflammation, depression, and neurodegenerative risk, but it's easy to improve with targeted nutrition, she adds. Iron: This essential mineral is key for the production of red blood cells. Low iron stores can affect your energy, thyroid function, and exercise capacity, Dr. Gidwani says. Ferritin: High ferritin can reflect inflammation or hemochromatosis (known as iron overload), which can cause serious damage to your heart, liver, pancreas, and even your joints, per Cleveland Clinic. Total iron binding capacity (TIBC): TIBC can also help diagnose iron overload and iron-deficiency anemia, per Cleveland Clinic. So what about my biological age score? Functional labs can sometimes calculate your biological age, which supposedly tells you how 'old' you are based on your bloodwork or a saliva test. Technically, biological age results are determined by looking at telomere length (DNA at the end of a chromosome) and by examining your 'epigenetic clock'—an analysis of your DNA patterns to help you see if you're truly aging slower or faster than your chronological age suggests, Dr. Gidwani says. But many companies estimate biological age by a combination of biomarkers like blood pressure, blood sugar, cholesterol levels, heart rate, height, and weight, per Cleveland it sounds fun to find your biological age, the metrics are questionable since every company likely uses a different method to land on a number, per Dr. Buttarazzi. So, if this marker is included on one of your extensive lab tests, you should probably take your results with a grain of salt. What do biomarkers really say about our health? Biomarkers are just one piece of the puzzle, and they shouldn't be seen as the end-all, be-all for your health. Biomarkers can tell you a lot, especially when it comes to identifying dysfunction and getting personalized guidance for healthspan and longevity, Dr. Gidwani says. But doctors say it's also important to back up and look at the big picture of what might be making you feel off—like lack of sleep or other lifestyle habits that could be hindering your health. And even the best data has its limits. Sometimes, biomarkers give us too much information that isn't relevant or that causes unnecessary worry, Dr. Gidwani says. Review results with a physician who can give you a full, holistic picture of your health—and ensure that you're on a path to long-term well-being. You Might Also Like Jennifer Garner Swears By This Retinol Eye Cream These New Kicks Will Help You Smash Your Cross-Training Goals
