Although cholesterol plays a role in the development of Alzheimer's disease, it is unclear if there is any relationship to blood serum cholesterol as opposed to brain cholesterol. Chemically the same cholesterol, brain cholesterol appears to be independent and unaffected by serum cholesterol levels. One reason is that the brain has a very tightly regulated barrier that controls what the brain gives and receives from our blood stream. It seems that serum cholesterol is impermeable to this blood brain barrier. Furthermore, brain cholesterol is largely produced by the brain itself and not from the liver or from our diet. And, lastly, brain cholesterol turnover is quite slow - on average half the brain cholesterol is replaced in ~5yrs. These may be some reason as to why statins do not seem to affect Alzheimer's disease.
Our understanding of the role of cholesterol and Alzheimer's disease is incomplete at best. Brain cholesterol does play a role in Alzheimer's disease but whether serum cholesterol is a factor is not clear. And today's evidence does not seem to support a role for the use of statin or other cholesterol lowering medications in the treatment of this disease.
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