Association Between Low-Density Lipoprotein Cholesterol Levels, Statin Use, and Dementia in Patients followed in German General Practices

Abstract

Background: No studies have been conducted to date on the association between low-density lipoprotein cholesterol (LDL-C), statin use classified into low, medium, and high statin dosages, and dementia in German general practices. Objective: The goal of this retrospective case-control study was to investigate the relationship between elevated LDL-C, statins, and dementia in elderly persons followed in general practices in Germany. Methods: This study included patients aged 65 or older with an initial dementia diagnosis between January 2015 and December 2019 and at least one documented LDL-C value within the year prior to the dementia diagnosis. These patients were treated in one of 963 general practices which document LDL-C in Germany. Dementia cases were matched to non-dementia controls using propensity scores based on age, sex, and comorbidities. Logistic regression models were conducted to assess a possible association between accelerated LDL-C, statins, and dementia. Results: The study included 12,236 patients with dementia and 12,236 non-dementia controls. In total, 2,528 of the dementia patients were diagnosed with vascular dementia. The use of all dosages of statin use was negatively associated with all-cause dementia (OR: 0.80 for low dose, OR: 0.92 for medium dose, and OR: 0.85 for high dose) and with vascular dementia (OR: 0.61 for low dose, OR: 0.77 for medium dose, and OR: 0.74 for high dose). There was no clinically relevant association between elevated LDL-C and dementia. Conclusion: A negative association was found between all dosage use of statin therapy and all-cause dementia and vascular dementia in elderly patients in general practices in Germany.

Variables associated with increased incidence of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes

“…In Germany, the sampling methods used to select physicians’ practices are appropriate for obtaining a representative database of general and specialized practices. 13 Finally, this database has already been used in previous studies focusing on diabetes 14 as well as NAFLD. 15 …”

“…In Germany, the sampling methods used to select physicians' practices are appropriate for obtaining a representative database of general and specialized practices. 13 Finally, this database has already been used in previous studies focusing on diabetes 14 as well as NAFLD. 15 Study population This retrospective cohort study included adult patients (≥18 years) with an initial diagnosis of T2D (index date) and at least one antihyperglycemic prescription between January 2012 and December 2018.…”

Overlap between irritable bowel syndrome and common gastrointestinal diagnoses: a retrospective cohort study of 29,553 outpatients in Germany

“…It has previously been shown that the panel of practices included in the Disease Analyzer database is representative of general and specialized practices in Germany [6]. Finally, this database has already been used in previous studies focusing on digestive system diseases [7][8][9][10].…”

Pharmacists’ Knowledge of Factors Associated with Dementia: The A-to-Z Dementia Knowledge List

“…Regarding lipid profile, there is no clear consensus, although statin treatment has been shown to reduce the risk of dementia in cohort studies [ 35 , 36 , 37 , 38 ]. Evidence suggests that high total cholesterol levels in mid-life increased the risk of AD in later life [ 6 ].…”