Lipoprotein(a) in the elderly: beyond atherosclerosis.

Lipoprotein(a) (= Lp(a)) concentration is generally related to vascular disease, and there are growing evidences that vascular factors play a role in the etiology of Alzheimer's disease (AD). We evaluated interactions of Lp(a) with lipid and non-lipid coronary artery disease (CAD) risk factors in free-living elderly subjects, from the randomized cohort of Casamassima (Bari, Southern Italy) of the Italian Longitudinal Study on Aging (ILSA). The results showed that in the elderly population high serum Lp(a) was not an independent predictor of CAD, but dependent on type 2 diabetes mellitus and elevated low-density lipoprotein (LDL) cholesterol levels, increasing risk of CAD by 6.65. Furthermore, we explored the possible role of serum Lp(a), apolipoprotein E (apoE) polymorphism, and total cholesterol (TC) serum levels in patients with diagnosis of probable AD, and healthy, unrelated age-matched controls. Lp(a) serum levels were significantly associated according to a nonlinear relationship with an increased risk for AD, independently of apoE genotypes and sex, and dependent on age and TC serum levels. We suggest that elevated Lp(a) serum levels, increasing the risk for cerebrovascular disease, may play a role in determining clinical AD.