Association of dietary cholesterol and egg intakes with the risk of incident dementia or Alzheimer disease: the Kuopio Ischaemic Heart Disease Risk Factor Study

Am J Clin Nutr. 2017 Feb;105(2):476-484. doi: 10.3945/ajcn.116.146753. Epub 2017 Jan 4.


Background: There is little information about the associations of intakes of cholesterol and eggs, a major source of dietary cholesterol, with the risk of cognitive decline in general populations or in carriers of apolipoprotein E ɛ4 (APO-E4), a major risk factor for dementia.

Objective: We investigated the associations of cholesterol and egg intakes with incident dementia, Alzheimer disease (AD), and cognitive performance in middle-aged and older men from Eastern Finland.

Design: A total of 2497 dementia-free men, aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study, were included in the study. Information on the apolipoprotein E (Apo-E) phenotype was available for 1259 men. Data on cognitive performance tests at the 4-y re-examinations were available for 480 men. Dietary intakes were assessed with the use of 4-d food records at baseline. Dementia and AD diagnoses were based on Finnish health registers. Cox regression and ANCOVA were used for the analyses.

Results: During the 21.9-y follow-up, 337 men were diagnosed with dementia, and 266 men were diagnosed with AD. Neither cholesterol nor egg intake was associated with a higher risk of incident dementia or AD. For example, when evaluated continuously, each intake of 100 mg cholesterol/d was associated with a multivariable-adjusted HR of 0.90 (95% CI: 0.79, 1.02) for incident dementia, and each additional 0.5 egg (27 g)/d was associated with an HR of 0.89 (95% CI: 0.78, 1.01). However, egg intake was associated with better performance on neuropsychological tests of the frontal lobe and executive functioning, the Trail Making Test, and the Verbal Fluency Test. The Apo-E4 phenotype did not modify the associations of cholesterol or egg intake (P-interactions > 0.11).

Conclusions: Neither cholesterol nor egg intake is associated with an increased risk of incident dementia or AD in Eastern Finnish men. Instead, moderate egg intake may have a beneficial association with certain areas of cognitive performance.

Keywords: Alzheimer disease; apolipoprotein E4; cholesterol; cognitive function; cognitive performance; dementia; eggs; population study.

MeSH terms

  • Adult
  • Alzheimer Disease / blood
  • Alzheimer Disease / epidemiology*
  • Animals
  • Apolipoprotein E4 / blood
  • Apolipoproteins E / blood
  • Cholesterol, Dietary / adverse effects*
  • Cognition
  • Cross-Sectional Studies
  • Dementia / blood
  • Dementia / epidemiology*
  • Eggs / adverse effects*
  • Energy Intake
  • Executive Function
  • Finland
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Myocardial Ischemia / blood
  • Myocardial Ischemia / epidemiology
  • Neuropsychological Tests
  • Prospective Studies
  • Risk Factors
  • Sensitivity and Specificity


  • Apolipoprotein E4
  • Apolipoproteins E
  • Cholesterol, Dietary