The dementia is one of the biggest concerns of old people, since it affects 10% of people who are over 60 years old. But many people have talked about the cognitive impairment it may be related to statin intake. For those who do not know, this is a drug that reduces low-density lipoprotein cholesterol, or bad cholesterol, so they are a fundamental treatment for the prevention of primary and secondary cardiovascular disease (CVD) events.
In this sense, the Food and Drug Administration (FDA) published a warning in 2012 about cases of apparent short-term cognitive decline with statin use. Of course, he recognized that the cardiovascular benefits outweigh its risks.
However, systematic reviews have not shown sufficient evidence on the impact of statins. In fact, research has shown conflicting results, with some showing a neurocognitive benefit from statins and others reporting no effect.
According to a study published in the ‘Journal of the American College of Cardiology’ (JACC), statin use in adults 65 years and older is not associated with dementia, mild cognitive impairment, or decline in individual cognitive domains.
The researchers in this study believe that since statins are widely used among older adults and their use is expected to increase, determining the effects of statin treatment on cognition in older individuals is vital in helping clinicians to weigh its benefits against the associated risks.
Long-term effects on cognitive decline
“As statins are increasingly being prescribed for older adults, their potential long-term effects on cognitive decline and dementia risk have attracted growing interest,” says Zhen Zhou, Ph.D. at the University’s Menzies Institute for Medical Research. from Tasmania (Australia) and lead author of the study. The present study adds to previous research by suggesting that baseline statin use was not associated with later incidence of dementia and long-term cognitive decline in older adults. ‘
The researchers in this study analyzed data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. This was a large prospective, randomized, placebo-controlled trial of daily low-dose ‘Aspirin’.
The study enrolled 19,114 participants aged 65 years or older with no previous events of CVD, dementia or significant physical disability, between 2010 and 2014, from Australia and the United States.
They were grouped based on baseline statin use and non-statin use. 5,898 (31.3%) of the participants were taking statins. The study aimed to measure outcomes, including incident dementia and its sub-classifications (probable Alzheimer’s disease (AD), mixed presentations); FBD and its sub-classifications (FBD consistent with EA, FBD-other); changes in domain-specific cognition, including global cognition, memory, language and executive function, and psychomotor speed; and in the composite of these domains.
Statin use is associated with risk
After a median of 4.7 years of follow-up, the researchers found 566 incident cases of dementia. This included probable AD and mixed presentations. Compared with no statin use, statin use was not associated with risk of all-cause dementia, probable AD, or mixed presentations of dementia.
380 incident cases of MCI were found (including MCI consistent with AD and MCI-other). Compared with no statin use, statin use was not associated with the risk of MCI, MCI consistent with AD, or other MCI.
There were no statistically significant differences in change in composite cognition or in any of the individual cognitive domains between statin users and non-users. There were also no significant differences in any of the outcomes of interest between hydrophilic and lipophilic statin users. However, the researchers found interaction effects between starting cognitive ability and statin treatment for all dementia outcomes.
The researchers specify that as it is a study, its results must be interpreted with caution. This will need to be confirmed by randomized clinical trials designed to explore the neurocognitive effects of statins in elderly populations.
In an accompanying editorial comment, Dr. Christie M. Ballantyne, a professor at Baylor College of Medicine in Houston, admits the study’s limitations, but agreed that the findings suggest that statins do not contribute to cognitive decline.