Objective: Evidence of a relation between use of lipid lowering drugs and cognitive outcomes is mixed. This study aimed to test the association between use of statins and incidence of dementia and cognitive impairment without dementia (CIND) over 5 years of follow-up.Methods: Data were from a population-based cohort study comprising 1,789 older Mexican Americans. All participants had cognitive and clinical evaluations performed every 12 to 15 months. Participants who fell below specified cutpoints on cognitive tests were then evaluated clinically. Dementia diagnoses were finalized by an adjudication team. A total of 1,674 participants free of dementia/CIND at baseline were included in these analyses. Statin use was verified at each participant's home by medicine cabinet inspection. Cox proportional hazards models were used to evaluate the association between statin use and incidence of dementia/CIND. Results:Overall, 452 of 1,674 participants (27%) took statins at any time during the study. Over the 5-year follow-up period, 130 participants developed dementia/CIND. In Cox proportional hazards models adjusted for education, smoking status, presence of at least one APOE 4 allele, and history of stroke or diabetes at baseline, persons who had used statins were about half as likely as those who did not use statins to develop dementia/CIND (HR ϭ 0.52; 95% CI 0.34, 0.80). Conclusion:Statin users were less likely to have incident dementia/cognitive impairment without dementia during a 5-year follow-up. These results add to the emerging evidence suggesting a protective effect of statin use on cognitive outcomes. Neurology The primary treatment benefit of statins is considered to be the reduction of low densitylipoprotein cholesterol (LDL-C) levels. [1][2][3][4][5][6][7][8] In most trials of cardiovascular morbidity/mortality, statin treatment was shown to reduce cardiovascular events 20% to 30%. [1][2][3][4][5][6] Other studies have indicated that statins have multiple actions beyond cholesterol lowering 7,9,10 ; these actions offer potential biologic mechanisms for the effect of statins on dementia.11 However, the evidence has been inconsistent about the relation of statin use and cognitive impairment. 12 The pattern of risk reductions seen in epidemiologic studies [13][14][15][16][17][18][19][20] continue to raise questions regarding the impact of statins on dementia. Earlier case-control studies [13][14][15] showed a protective effect of lipid lowering agents on the incidence of dementia. A later study 19 provided evidence that indication bias may have been present in the earlier reports. The second wave of observational Disclosure: Caryn Cramer was employed by Pfizer Corporation during completion of her doctoral degree during which time this study was conducted. Pfizer did not provide any material support for this study, and did not participate in the design, conduct, management, analysis, interpretation, review, or approval of the study or the manuscript. The other authors have reported no conflicts of inte...
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