Statin Use and the Risk of Incident Dementia: The Cardiovascular Health Study.
Rea, Thomas D. MD, MPH; Breitner, John C. MD; Psaty, Bruce M. MD, PhD; Fitzpatrick, Annette L. PhD; Lopez, Oscar L. MD; Newman, Anne B. MD, MPH; Hazzard, William R. MD; Zandi, Peter P. PhD, MPH; Burke, Gregory L. MD, MS; Lyketsos, Constantine G. MD, MHS; Bernick, Charles MD; Kuller, Lewis H. MD, DrPH
[Miscellaneous]
Archives of Neurology.
62(7):1047-1051, July 2005.
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Background: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular risk through mechanisms that might affect the development of dementia.
Objective: To evaluate whether statin use is associated with a lower risk of dementia compared with never use of lipid-lowering agents (LLAs).
Design: Cohort study of community-dwelling adults 65 years and older. The analysis included 2798 participants free of dementia at baseline.
Main Outcome Measures: Using Cox proportional hazards regression analysis, we estimated the risk of incident all-cause and type-specific dementia associated with time-dependent statin therapy compared with never use of LLAs. The primary analyses incorporated a 1-year lag between exposure and outcome. Secondary analyses included the final year of exposure and modeled statin use as current use vs nonuse to simulate a case-control approach.
Results: Compared with never use of LLAs, ever use of statins was not associated with the risk of all-cause dementia (multivariable-adjusted hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.77-1.52), Alzheimer disease alone (HR, 1.21; 95% CI, 0.76-1.91), mixed Alzheimer disease and vascular dementia (HR, 0.87; 95% CI, 0.44-1.72), or vascular dementia alone (HR, 1.36; 95% CI, 0.61-3.06). In contrast, in secondary analyses, current use of statins compared with nonuse of LLAs was associated with HRs of 0.69 (95% CI, 0.46-1.02) for all-cause dementia and 0.56 (95% CI, 0.35-0.92) for any Alzheimer disease.
Conclusions: In this cohort study, statin therapy was not associated with a decreased risk of dementia. Methodological differences may explain why results of this cohort investigation differ from those of prior case-control studies. Additional investigation is needed to determine whether and for whom statin use may affect dementia risk.
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