Researchers examined data on 18,846 adults 65 years and older who participated in the ASPREE (Aspirin in Reducing Events in the Elderly) trial and had no history of cardiovascular events, dementia, or major physical disability. A total of 5,898 (31.3%) participants used statins at baseline.
After a median follow-up period of 4.7 years, 566 cases of incident dementia were recorded. Statins were not associated with the risk of all-cause dementia, probable Alzheimer's disease, or mixed presentations of dementia, the study team reports in the Journal of the American College of Cardiology.
During follow-up, there were also 380 cases of incident mild cognitive impairment, which were not found to be associated with statin use. There was also no association between statins and the rate of change in composite cognition or any individual cognitive domains.
"These study findings can reassure clinicians as to the safety of a widespread use of statins in the elderly," said lead study author Zhen Zhou of the University of Tasmania in Australia.
"However, the rare circumstances of statin-related cognitive problems such as a short-term memory loss cannot be precluded," Zhou said by email.
For the study, Zhou and colleagues identified dementia based on DSM-4 criteria, which include memory impairment as well as at least one of these other diagnoses: aphasia, apraxia, agnosia, and impaired executive functioning. Cognitive impairment also needed to be pronounced enough to impair activity in work or social life and represent a marked decline from prior abilities.
Participants had cognitive function assessments at baseline and again at years 1, 3, 5 and during a final visit. The battery of tests included the 3MS, the Symbol Digit Modalities Test, the Hopkins Verbal Learning Test-Revised, and the single-letter Controlled Oral Word Association Test.
One limitation of the study is a lack of data on the duration of statin use, or the dosage prescribed, the authors note. Because participants didn't have dementia at baseline, the results also don't help illustrate whether statins would worsen cognitive function or symptoms in people who already have dementia.
However, there have been numerous other clinical trials and meta-analyses which have not shown any effect of statins on incident dementia or cognitive impairment, said Dr. Christie Ballantyne, Chief of Cardiology and Cardiovascular Research at Baylor College of Medicine in Houston, Texas, and coauthor of a commentary accompanying the study.
The current study results add to this body of evidence suggesting that statins don't lead to dementia, Dr. Ballantyne said by email.
"Individuals who have hypertension, diabetes and high cholesterol in middle age have an increased risk for both more rapid cognitive decline and dementia in old age," Dr. Ballantyne said. "Therefore, efforts on healthy lifestyle in addition to pharmacotherapy are important not only to improve risk factors and reduce cardiovascular disease but also for healthy aging and avoiding cognitive decline and dementia."
SOURCE: https://bit.ly/3x8fW7A and https://bit.ly/3w70aJ5 Journal of the American College of Cardiology, online June 21, 2021.
By Lisa Rapaport
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