Healthy Heart, Healthy Mind: Lowering Cholesterol for Brain Health

Written By Jennifer Palmquist

When it comes to preserving memory and cognitive abilities, most people think about things like brain games, exercise, and maybe keeping blood pressure in check. These are all important – and if you’re already taking walks or learning new skills to boost your brain health, you’re on the right path. But there’s another mid-life health factor you might not immediately connect with brain health: your cholesterol levels. 

High LDL cholesterol (i.e., the so-called “bad” cholesterol) in midlife has now been identified as a modifiable risk factor for dementia. The American Heart Association has declared “what’s good for the heart is good for the brain” because the same fatty cholesterol particles that can clog your arteries also deprive your brain of healthy blow flow and the oxygen and nutrients that blood carries. By managing cholesterol, you can take a big step toward protecting your cognitive future. Let’s dive into why midlife cholesterol matters for the brain and what you can do about it.

But it's important to remember, this is only one of many modifiable behavioral risk factors for Alzheimer's and dementia. 

If you'd like a personalized plan, daily activities and support to help address all of your most pressing risks, sign up for a 2 week free trial of Mindr. Better brain health starts today. 

The Link Between Cholesterol and Cognitive Decline

Cholesterol isn’t entirely villainous - quite the opposite actually!  Your body needs it to build and repair cells, produce hormones and digest fats. But an excess of the wrong kind, particularly LDL (low-density lipoprotein), spells trouble. LDL particles deposit fatty plaques in blood vessels. Over time, this build-up can stiffen and block arteries, including those that feed the brain. Reduced blood flow means brain cells receive less oxygen and nutrients. High cholesterol also raises the risk of stroke, which can directly injure the brain. In essence, what clogs the heart’s arteries can also impair the brain’s blood supply, contributing to cognitive impairment.

Beyond vessel damage, scientists are exploring direct effects of cholesterol on the brain. Fascinating new research suggests that excess LDL cholesterol might trigger or exacerbate accumulation of toxic proteins in the brain. One study found that LDL can bind to the tau protein (implicated in Alzheimer’s disease), helping it aggregate into tangles that damage neurons. Those LDL-tau complexes may even cross the blood-brain barrier, accelerating dementia-related changes. While this research is ongoing, it underscores a critical point: midlife cholesterol levels can set the stage for brain changes decades later.

The Lancet Commission’s on dementia’s 2024 report included a review of 27 studies and concluded that higher LDL cholesterol is associated with higher incidence of dementia. In these analyses, having elevated total cholesterol or low HDL (“good” cholesterol) in midlife was linked to greater risk of developing dementia in later life. How much higher is the risk? Multiple long-term studies have found that people with high cholesterol in their 40s and 50s have about a 20–40% higher chance of dementia in old age compared to those with healthy levels. One British expert noted that “the link between high cholesterol levels in middle age and the later onset of dementia now seems to be proven”, given the wealth of data. That is a sizable increase in risk – but remember, it’s a modifiable risk.

The encouraging flip side is that managing cholesterol appears to reduce or even neutralize that added risk. Some research suggests that long-term use of cholesterol-lowering medications (statins) is associated with lower rates of dementia, especially vascular dementia. The evidence on statins is mixed (and scientists are still studying if statins directly protect the brain), but many studies show no cognitive harm from statins – if anything, they may be slightly protective, likely by improving vascular health. 

What’s clear is that keeping your cholesterol in check is part of keeping your brain healthy. It aligns with the broader principle that a healthy heart and blood vessels support a healthier brain. Factors like smoking, high cholesterol, and hypertension in midlife all elevate dementia risk, whereas controlling them can cut that risk down. In fact, experts now urge that everyone over the age of 20 get their cholesterol tested regularly and treated if it’s high, as a strategy to prevent dementia later on. Midlife really is the critical window to act – before years of high cholesterol do irreversible harm.

Taking Action: Manage Cholesterol for a Healthier Brain

You can take concrete steps to manage your cholesterol, and by doing so you’ll be benefitting your brain as well as your heart. Here are some guidelines and tips to get you started:

  • Know your numbers: Check your cholesterol early and often. Knowledge is power. If you’re in your 40s, 50s, or early 60s and haven’t had a cholesterol panel recently, talk to your healthcare provider about getting one. It’s a simple blood test. You’ll learn your LDL, HDL, total cholesterol, and triglycerides. Many people with high cholesterol feel no symptoms at all. By checking, you might catch an issue early when it’s easier to manage. Given the new findings, some experts are calling for routine cholesterol screening starting in early adulthood. So, be proactive and know your numbers – it’s the first step in taking control.

  • Heart-Healthy Eating is Brain-Healthy Eating: Diet has a huge influence on cholesterol levels. Embrace a heart-healthy diet that’s naturally good for your brain too. This means limiting saturated and trans fats (the kinds that raise LDL) and emphasizing fiber-rich, unsaturated-fat foods that improve your lipid profile. Start by cutting back on red and processed meats, butter, full-fat dairy, and fried foods. Instead, choose lean proteins (like fish and poultry), plenty of vegetables and fruits, whole grains, nuts, seeds, and healthy oils (olive oil, avocado). For example, swap cream-based dressings for olive oil and vinegar, or choose salmon instead of steak sometimes. These changes can lower your LDL and raise HDL. Also, watch out for added sugars and excessive alcohol, which can raise triglycerides (another blood fat). A Mediterranean-style or DASH diet is a great model – studies link these diets to both better cardiovascular health and sharper cognitive function.

  • Stay Active and Maintain Healthy Weight: Regular physical activity can boost your “good” HDL cholesterol and lower the “bad” stuff, while also improving blood flow to the brain. Aim for at least 150 minutes of moderate exercise a week (brisk walking, cycling, swimming, dancing – whatever you enjoy). Exercise helps your body use up triglycerides and keeps your arteries flexible. It’s also a proven mood and memory booster. Coupled with a healthy diet, exercise will help keep your weight in check – which matters because being overweight in midlife is itself a risk factor for dementia (and often goes hand-in-hand with high cholesterol). If you find it hard to start, begin with small steps: a 10-minute walk during lunch breaks, taking the stairs, or a few wall pushups during a commercial break. It all counts. Over time, you’ll improve your cholesterol numbers and your brain will reap the benefits of better blood circulation and fitness.

  • Manage Blood Pressure and Blood Sugar: Cholesterol is one part of the bigger metabolic picture. Often, high cholesterol teams up with high blood pressure or pre-diabetes – a combination that can damage blood vessels even more. By addressing one, you often help the others. For instance, losing weight and eating better will likely lower your blood pressure and stabilize blood sugar along with cholesterol. This clustered approach is exactly what comprehensive brain-health programs recommend. In fact, the landmark FINGER study in Finland and the U.S. POINTER trial showed that a multi-domain lifestyle intervention – diet, exercise, and managing vascular risk factors – improved cognitive function by 25% more than usual care. Managing cholesterol and blood pressure was a key part of those interventions. Take advantage of your annual physical to check blood pressure, glucose, and cholesterol together. They often influence each other, and tuning up your overall metabolic and cardiovascular health can substantially lower your risk of dementia.

  • Consider Medications When Appropriate: If lifestyle changes alone aren’t enough to get your LDL cholesterol to a healthy range, medications can be a game-changer. The most common are statins (which are very effective at lowering LDL) but there are other options for those who need them. Early prevention is ideal, so if your doctor prescribes cholesterol-lowering medicine, take it as directed. It’s never too late though! The PREVENTABLE study led by Duke is currently testing whether a statin in adults 75+ can prevent dementia and disability.

  • Don’t Smoke, Moderate Alcohol: Smoking damages blood vessels and worsens cholesterol (it lowers HDL and makes LDL more toxic). If you smoke, seek help to quit. It’s one of the best things you can do for both your heart and your brain. Excessive alcohol can also raise triglycerides and blood pressure, harming your cardiovascular health and cognition. Moderation is key - no more than 1 drink a day for women, 2 for men, as a general guideline. 

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Keeping it in Perspective

Managing your cholesterol isn’t about depriving yourself or stressing over numbers – it’s about taking back control. Every healthy swap you make (e.g., fruit instead of chips, a bike ride instead of an extra TV episode) is a win for your brain. Over time, these choices build up resilience against the changes that cause high cholesterol and ultimately dementia. 

You don’t have to do it perfectly; just making progress is what counts. High cholesterol is a solvable problem for most of us. Lifestyle changes and medication can make a world of difference. By tackling this risk factor, you’re stacking the odds in favor of a clear mind and healthy body as you age. The saying “healthy heart, healthy mind” is more than a cliché; it’s a scientific fact. Here’s to clear arteries and a bright mind for years to come!

What’s Next?

Sometimes managing cholesterol and all the lifestyle choices which go along with it can feel overwhelming but you don’t have to do this alone. Mindr can help! Many studies, including the U.S. POINTER trial, a study of lifestyle changes conducted by the Alzheimer’s Association, have shown that coaching support and structured intervention plans give people a statistically significant edge over those who are self-guided. 

With Mindr, you will have access to all of these success boosting tools:

  • An easy to follow personalized cholesterol reduction plan that fits your life

  • Additional personalized plans for your most pressing risk factors

  • Daily guidance so you know exactly what to do each day

  • Frequent assessments and tracking so you can see your progress

  • A human in the loop to support and encourage you

You wouldn’t still be reading this if having a healthy brain wasn’t important to you. The lifestyle changes that will get you there are within your reach. You have the will, we’ll show you the way - one day at a time. You can do this and we can help.

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References: 

Jennifer Palmquist
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