Familial hypercholesterolemia (FH) is a genetic lipid disorder characterized by lifelong exposure to high levels of LDL cholesterol (LDL-C), which promotes the progression of atherosclerosis and markedly increases the risk of atherosclerotic cardiovascular disease (ASCVD), especially from early life [1]. Early diagnosis and timely initiation of lipid-lowering therapy (LLT) are crucial for preventing vascular complications and improve long-term outcomes [2]. Beyond its well-established role in ASCVD, elevated LDL-C may also be associated with cognitive impairment in hypercholesterolemic individuals [3].