Statin exposure and the risk of dementia in individuals with hypercholesterolaemia

Abstract

Objectives This study aimed to examine the association between statin exposure and dementia risk in individuals with hypercholesterolaemia using data from the NHIS‐HEALS database between 2002 and 2015. Methods Subjects were classified into statin exposure and statin nonexposure groups according to medication possession ratio. Dementia was defined as those with primary diagnostic dementia codes such as F00‐F03, G30, G31.1, G31.9 or G31.82. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate the prospective association between statin exposure and dementia risk. Results During the follow‐up period (median follow‐up 11.7 years), 711 cases of dementia occurred, accounting for 11.5% of the total study population (statin exposure group, 8.2%; statin nonexposure group, 12.9%). Compared to the statin nonexposure group, fully adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for overall dementia in the statin exposure group were 0.63 (0.43–0.91) and 0.62 (0.50–0.78) in men and women, respectively. Compared to the statin nonexposure group, the HRs (95% CIs) for Alzheimer’s disease and related dementia, vascular dementia and other types of dementia in the statin exposure group were 0.54 (0.32–0.91), 2.45 (0.69–8.68) and 0.59 (0.32–1.07), respectively, in men and 0.53 (0.38–0.73), 1.29 (0.42–3.96) and 0.70 (0.51–0.96), respectively, in women. Conclusions Hypercholesterolaemic individuals exposed to statin had a lower risk of overall dementia and Alzheimer’s disease and related dementia in both sexes, and a lower risk of other types of dementia in women, than subjects who were not exposed to statins.

Association of Familial Hypercholesterolemia and Statin Use With Risk of Dementia in Norway

“…1 There are many different forms of dementia, of which Alzheimer disease (AD) is the most common, accounting for 60% to 80% of all cases. 1 , 2 , 3 , 4 It is estimated that by 2050, 1 in 85 persons worldwide will have dementia. 5 The incidence of AD is approximately 13% among individuals aged 65 years and older and 45% among individuals aged 85 years and older.…”

Clinical Practice Guidelines for Managing Frailty in Community-Dwelling Korean Elderly Adults in Primary Care Settings

“…In the outpatient clinic of the primary care setting, such multifactorial interventions can be considered selectively for frail elderly adults with mild cognitive impairment [ 30 , 31 , 89 , 105 ]. These interventions are mainly composed of non-pharmacological therapy, including (1) prevention by controlling cardio-cerebrovascular risk factors [ 106 - 108 ], (2) physical activity and exercise therapy [ 89 , 105 , 109 ], and (3) cognitive training [ 110 ]. There is a lack of evidence as to whether pharmacological treatment is helpful in cognitive intervention for patients with frailty.…”

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“…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 ].…”