Statin Use, Incident Dementia and Alzheimer Disease in Elderly African Americans

Hendrie, Hugh C.; Hake, Ann Marie; Lane, Kathleen A.; Purnell, Christianna; Unverzagt, Frederick W.; Smith-Gamble, Valerie; Murrell, Jill R.; Ogunniyi, Adesola; Baiyewu, Olusegun; Callahan, Chris; Saykin, Andrew J.; Taylor, Stanley; Hall, Kathleen; Gao, Su

doi:10.18865/ed.25.3.345

Cited by 43 publications

(26 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eight studies [21–23,33,35,46,51,52] reported adjusted ORs instead of HRs (11,336 participants and 1,001 stroke events). The pooled estimate indicated increased odds of incident dementia in those with prevalent stroke compared to no prevalent stroke (pooled OR = 1.53, 95% CI: 1.30–1.80, p<0.00001, I 2 = 0%; 95% PI: 1.22 – 1.84; Fig.…”

Section: Resultsmentioning

confidence: 99%

Stroke and dementia risk: A systematic review and meta‐analysis

Kuźma

Lourida

Moore

et al. 2018

Alzheimer's & Dementia

250

159

View full text Add to dashboard Cite

INTRODUCTION: Stroke is an established risk factor for all-cause dementia, though meta-analyses are needed to quantify this risk. METHODS: We searched Medline, PsycINFO and Embase for studies assessing prevalent or incident stroke versus a no-stroke comparison group and the risk of all-cause dementia. Random effects meta-analysis was used to pool adjusted estimates across studies and meta-regression was used to investigate potential effect modifiers. RESULTS: We identified 36 studies of prevalent stroke (1.9 million participants) and 12 studies of incident stroke (1.3 million participants). For prevalent stroke, the pooled hazard ratio for all-cause dementia was 1.69 (95% CI: 1.49–1.92; p<0.00001; I2 = 87%). For incident stroke, the pooled risk ratio was 2.18 (95% CI: 1.90–2.50; p<0.00001; I2 = 88%). Study characteristics did not modify these associations, with the exception of sex which explained 50.2% of between-study heterogeneity for prevalent stroke. DISCUSSION: Stroke is a strong, independent, and potentially modifiable risk factor for all-cause dementia.

show abstract

Section: Resultsmentioning

confidence: 99%

Stroke and dementia risk: A systematic review and meta‐analysis

Kuźma

Lourida

Moore

et al. 2018

Alzheimer's & Dementia

250

159

View full text Add to dashboard Cite

show abstract

“…A small number of studies have examined statins and cognitive dysfunction,3,13 with few specifically examining this association in CAD patients as a primary outcome 28. Because high-dose statins are often prescribed in CAD,29 the potential risk of low LDL levels on cognition are of particular concern.…”

Section: Introductionmentioning

confidence: 99%

Serum low-density lipoprotein levels, statin use, and cognition in patients with coronary artery disease

Rej¹,

Saleem

Herrmann

et al. 2016

NDT

View full text Add to dashboard Cite

AimStatins have been associated with decreased cognition due to the effects of low concentrations of low-density lipoprotein (LDL) on brain function. This has remained controversial and is particularly relevant to patients with coronary artery disease (CAD), who have an increased risk of cognitive decline and are frequently prescribed statins. This study hypothesized that low concentration of LDL is associated with poor cognition in CAD patients using statins. It also explored the association between high-dose versus low-dose statins on cognition in this population.Patients and methodsBaseline cross-sectional data from a longitudinal study of 120 statin-using CAD patients were examined (mean statin duration 25±43 months). The main outcomes were measures of global cognition and cognitive domains, with poor cognition defined as cognitive performance ≤1 standard deviation below the population age and education adjusted means. A battery of cognitive tests was used to assess verbal memory, executive function, speed of processing, visuospatial memory, and global cognition. Adjusting for age, sex, education, and other covariates, multivariable logistic regression analyses assessed associations between low LDL levels (<1.5 mmol/L), statin use, and poor cognition.ResultsLDL levels were not associated with global cognition or individual cognitive domains. High-dose statin use was associated with higher visuospatial memory (odds ratio, OR [95% confidence interval, CI] =0.12 [0.02–0.66], P=0.01) and executive functioning (OR =0.25 [0.06–0.99], P=0.05). This effect was independent of covariates such as LDL levels.ConclusionLow LDL levels do not appear to be associated with poor cognition in CAD patients using statins. Whether high-dose statin use may have positive effects on cognition in CAD patients could be investigated in future studies.

show abstract

“…Seven cohort studies Chuang, Lin, Lin, Sung, & Kao, 2015;Hendrie et al, 2015;Hippisley-Cox & Coupland, 2010;Li et al, 2010;Yang et al, 2015) and five case control studies (Booker et al, 2016;Chen, Liu, Chen, & Wu, 2014;Corrao et al, 2013;Horsdal et al, 2009;Lin et al, 2015) found that statin use was associated with a reduced risk of dementia. According to these studies, beginning treatment with high doses of lipophilic statins before an early old age (<80 years old) and taking these statins for a long time might reduce the risk of dementia.…”

Section: Statinsmentioning

confidence: 99%

Drug interactions with dementia‐related pathophysiological pathways worsen or prevent dementia

Barus

Béné

Deguil

et al. 2019

British J Pharmacology

View full text Add to dashboard Cite

Many risk factors are known to induce or precipitate dementia. Drugs acting via different mechanisms can modulate cognitive performance and exert either beneficial or deleterious effects on cognition through functional or neuropathological mechanisms. This review discusses the association between several classes of drugs and cognitive impairment and dementia risk. These drugs can be divided into drugs targeting CNS disorders (e.g., anticholinergic drugs, antiepileptics, antipsychotics, benzodiazepines, and opioids) and drugs targeting non‐CNS disorders (e.g., antidiabetics, antihypertensives, proton pump inhibitors, and statins). Furthermore, we sought to highlight the pharmacological mechanisms underlying their possible detrimental or beneficial effects on cognition. Anticholinergic and antiepileptic drugs were excluded from this review because their effects on cognition are well known. Studies investigating benzodiazepines have revealed an increased risk of dementia. Conclusions on dementia risk or cognitive impairment regarding opioids and antipsychotic drugs are difficult to draw. These different classes appear to impair cognition not by a single clear mechanism of action specific to each class but by several relatively interdependent and interconnected mechanisms (e.g., impaired neurotransmission, neuroinflammation, neuronal death, oxidative stress, or interactions with dementia‐related pathways). The dementia risk initially associated with the use of proton pump inhibitors might have been overestimated. In contrast, statins, antihypertensive medications, and antidiabetics could potentially decrease the risk of dementia and cognitive impairment by acting in ways opposite to the mechanisms cited above. Linked Articles This article is part of a themed section on Therapeutics for Dementia and Alzheimer's Disease: New Directions for Precision Medicine. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.18/issuetoc

show abstract

Statin Use, Incident Dementia and Alzheimer Disease in Elderly African Americans

Cited by 43 publications

References 41 publications

Stroke and dementia risk: A systematic review and meta‐analysis

Stroke and dementia risk: A systematic review and meta‐analysis

Serum low-density lipoprotein levels, statin use, and cognition in patients with coronary artery disease

Drug interactions with dementia‐related pathophysiological pathways worsen or prevent dementia

Contact Info

Product

Resources

About