Cholesterol Isn’t Just About Heart Health—It May Be the Missing Link In Alzheimer’s, Says New Study

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  • 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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