Statins and cognitive function in the elderly

Bernick, Charles; Katz, Ronit; Smith, Nick L.; Rapp, Stéphen R.; Bhadelia, Rafeeque A.; Carlson, Michelle C.; Kuller, Lewis H.

doi:10.1212/01.wnl.0000182897.18229.ec

Cited by 137 publications

(73 citation statements)

References 36 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Not only antihypertensive drugs (especially renin-angiotensin-aldosterone system blockers) but also antihyperlipidemic drugs (especially statins) might have a preventive effect against CKD, 34 neuropathological degeneration and cognitive decline. [35][36][37] Thus, lack of information about such medications may have been responsible for the result that there was no significant association between cerebral atrophy and hypertension or hyperlipidemia. Finally, as our study sample size was relatively small, categorical variables, such as age (per decade), sex, severity of WMH and subjects with GFR o60 ml min À1 per 1.73 m 2 , appeared to have a high odds ratio (approximately two-to fivefold), as well as wide 95% confidence interval ranges, for predicting cerebral atrophy.…”

Section: Resultsmentioning

confidence: 99%

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Yakushiji

Nanri

Hirotsu³

et al. 2010

Hypertens Res

View full text Add to dashboard Cite

The relationship between kidney dysfunction, such as chronic kidney disease (CKD), and brain morphology has attracted increasing attention, but the association between kidney dysfunction and cerebral atrophy has yet to be determined. The purpose of this study was to clarify the relationship between kidney function and a substantial degree of cerebral atrophy. A total of 610 consecutive Japanese adults without neurological disorders who had undergone health screening tests of the brain were studied prospectively. Magnetic resonance imaging was performed using a 1.5-T scanner. Using a computer-assisted processing system, the percentage of cerebrum atrophy (%Cerebrum atrophy) was calculated as an index of cerebral atrophy. Atrophy was defined as 42 s.d.s below the mean %Cerebrum atrophy. The glomerular filtration rate (GFR) was estimated using the revised equations for estimated GFR from serum creatinine in Japan. Kidney function variables included the GFR value and the prevalence of subjects with GFR o60 ml min À1 per 1.73 m 2 . Cerebral atrophy was found in 25 (4.1%) cases. Univariate analysis showed that age, male sex, hypertension, each kidney function variable, white matter hyperintensities and lacunae were associated with cerebral atrophy. On logistic regression analysis, GFR (odds ratio (OR), 0.64; 95% confidence interval (CI), 0.42-0.98) and GFR o60 ml min À1 per 1.73 m 2 (OR, 5.93; 95% CI,) were significantly associated with cerebral atrophy. On subanalysis, GFR o60 ml min À1 per 1.73 m 2 was significantly associated with cortical atrophy (OR, 3.23; 95% CI, 1.15-9.11). Decreased GFR was significantly associated with cerebral atrophy, indicating that treatment of CKD may control age-related degenerative processes of the brain.

show abstract

Section: Resultsmentioning

confidence: 99%

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Yakushiji

Nanri

Hirotsu³

et al. 2010

Hypertens Res

View full text Add to dashboard Cite

show abstract

“…On the one hand, statins were found to have beneficial effects on cognition in the non-demented elderly in three clinical trials [6][7][8] and in three community or populationbased surveys [9][10][11]. On the other hand, one randomized clinical trial has showed that statins may cause detrimental effects on cognitive performance in hypercholesterolemic adults aged 35-70 years [12].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, cognitive function was unaffected in the elderly in two placebo-controlled trials of statin treatment [13,14]. In all but three of these previous studies, participants were ascertained through clinical trials [9][10][11]. Therefore, selection factors may have influenced the findings of the clinical trials [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, selection factors may have influenced the findings of the clinical trials [6][7][8]. In addition, unmeasured confounders, including medications that potentially affect cognitive function (e.g., anxiolytics, stimulants, antipsychotics, antidepressants, antihistamines, or antiepileptics drugs) [15] may have influenced the results of previous clinical trials [6,8,12,13] and community or population-based surveys outcomes [9][10][11]. We conducted a cross-sectional study of cognitive function in people treated with statins in a population-based elderly Spanish cohort.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Statins and Cognitive Functioning in the Elderly: A Population-Based Study

Benito-León

Louis

Vega³

et al. 2010

JAD

View full text Add to dashboard Cite

Abstract. In a 2009 Cochrane review, the authors concluded that there is good evidence that statins, given in late life to people at risk of vascular disease, have no effect in preventing Alzheimer's disease or dementia. A related issue, which remains unclear, is whether statins improve cognitive function. While some studies have shown a beneficial effect of statins on cognitive function, others have observed mild detrimental effects on cognition. Our aim was to assess cognitive function in community-dwelling elderly participants treated with statins compared with their untreated counterparts (i.e., controls) living in the same population. 137 population-dwelling participants who were receiving statins and 411 matched controls age 65 years (median = 72 years) in central Spain (the Neurological Disorders in Central Spain [NEDICES] study) underwent a neuropsychological assessment, including tests of global cognitive performance, frontal-executive function, verbal fluency, and memory. Median duration of statin treatment was 2 years. Of 137 participants receiving statins, 53 (38.7%) were taking pravastatin, 38 (27.7%) simvastatin, 37 (27.0%) lovastatin, 6 (4.4%) fluvastatin, and 3 (2.2%) atorvastatin. Although initial univariate analyses indicated some differences, after adjusting for age, gender, education, depressive symptoms, premorbid intelligence, medications that potentially affect cognitive function, and blood cholesterol levels, statin users and controls performed similarly on all neuropsychological tests. In this population-based sample, elderly participants treated with statins and untreated controls performed similarly in all tested cognitive areas. These results do not support a positive benefit of statins on cognition.

show abstract

“…To date two large population-based cohort studies of cognitively healthy persons over 60 years of age have provided conflicting results regarding the primary preventive effect of statins on AD [31, 32]. Additionally, two intervention studies investigating the primary prevention of cognitive deficits using statins came to the result that statins reduce cardiovascular and cerebrovascular risk, but show no advantage in cognitive functioning [33, 34].…”

Section: Pharmacological Treatment Of MCImentioning

confidence: 99%

Pharmacological Treatment of Mild Cognitive Impairment as a Prodromal Syndrome of Alzheimer's Disease

Karakaya

Fußer²,

Schröder³

et al. 2013

Current Neuropharmacology

View full text Add to dashboard Cite

Mild cognitive impairment (MCI) is a syndrome which, depending on various neurobiological, psychological and social factors, carries a high risk of developing into dementia. As far as diagnostic uncertainty and the heterogeneous underlying pathophysiological mechanisms are concerned, only limited therapeutic options are currently available. Clinical trials involving a wide range of substances have failed to show efficacy on primary and secondary outcome parameters. Most results reflect not only a lack of effectiveness of drug therapy but also methodological constraints in true prodromal Alzheimer´s disease (AD) based on clinical criteria. Biomarkers may help to identify MCI as a prodromal phase of dementia, so it is important to use them to improve specificity of case selection in future studies. For MCI as a prodromal syndrome of AD, clinical trials with disease modifying drugs that target underlying pathological mechanisms such as amyloid-beta accumulation and neurofibrillary tangle formation may help develop effective treatment options in the future. Alternative pharmacological approaches are currently being evaluated in ongoing phase 1 and phase 2 studies. Nevertheless, a lack of approved pharmacotherapeutic options has led to specific interventions that focus on patient education and life-style related factors receiving increasing attention.

show abstract

Statins and cognitive function in the elderly

Abstract: Statin drug use was associated with a slight reduction in cognitive decline in an elderly population. This relationship could not be completely explained by the effect of statins on lowering of serum cholesterol.

Cited by 137 publications

References 36 publications

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Statins and Cognitive Functioning in the Elderly: A Population-Based Study

Pharmacological Treatment of Mild Cognitive Impairment as a Prodromal Syndrome of Alzheimer's Disease

Contact Info

Product

Resources

About