Statins for the prevention of dementia

McGuinness, Bernadette; Craig, David; Bullock, Roger; Passmore, Peter

doi:10.1002/14651858.cd003160.pub2

Cited by 203 publications

(200 citation statements)

References 100 publications

Supporting

Mentioning

185

Contrasting

Unclassified

Order By: Relevance

“…First, we recorded all statin RCTs in the inclusion and exclusion lists of three Cochrane reviews. Two examined the effectiveness of statins for the prevention 23 and treatment of dementia, 24 covering literature through 2007 and 2008, respectively, and one examined primary prevention of cardiovascular outcomes, 25 covering literature through 2007. Second, we conducted electronic searches for RCTs of statins crossed with search terms for neurocognitive outcomes through 2008, designed to identify additional RCTs that the Cochrane reviews might have excluded at the abstract level.…”

Section: Data Sources and Searchesmentioning

confidence: 99%

Do Statins Impair Cognition? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2015

View full text Add to dashboard Cite

BACKGROUND:In 2012, the United States Food and Drug Administration (FDA) issued a warning regarding potential adverse effects of HMG-CoA reductase inhibitors (statins) on cognition, based on the Adverse Events Reporting System and a review of the medical literature. We aimed to synthesize randomized clinical trial (RCTs) evidence on the association between statin therapy and cognitive outcomes. METHODS: We searched MEDLINE, EMBASE, and Cochrane CENTRAL through December 2012, and reviewed published systematic reviews of statin treatment. We sought RCTs that compared statin treatment versus placebo or standard care, and reported at least one cognitive outcome (frequency of adverse cognitive events or measurements using standard neuropsychological cognitive test scores). Studies reporting sufficient information to calculate effect sizes were included in metaanalyses. Standardized and unstandardized mean differences were calculated for continuous outcomes for global cognition and for pre-specified cognitive domains. The main outcome was change in cognition measured by neuropsychological tests; an outcome of secondary interest was the frequency of adverse cognitive events observed during follow-up. RESULTS: We identified 25 RCTs (all placebo-controlled) reporting cognitive outcomes in 46,836 subjects, of which 23 RCTs reported cognitive test results in 29,012 participants. Adverse cognitive outcomes attributable to statins were rarely reported in trials involving cognitively normal or impaired subjects. Furthermore, meta-analysis of cognitive test data (14 studies; 27,643 participants) failed to show significant adverse effects of statins on all tests of cognition in either cognitively normal subjects (standardized mean difference 0.01, 95 % confidence interval, CI, −0.01 to 0.03, p=0.42) or Alzheimer's disease subjects (standardized mean difference −0.05, 95 % CI −0.19 to 0.10, p=0.38). CONCLUSIONS: Statin therapy was not associated with cognitive impairment in RCTs. These results raise questions regarding the continued merit of the FDA warning about potential adverse effects of statins on cognition.

show abstract

Section: Data Sources and Searchesmentioning

confidence: 99%

Do Statins Impair Cognition? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Indeed, a growing literature, with mixed results, has examined whether the use of these medications might lower the odds or risk of AD [2][3][4]. However, 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 AD or dementia [5].…”

Section: Introductionmentioning

confidence: 99%

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

“…In different investiga-tions, cholesterol level was rather analyzed as a risk factor of atherogenesis but not the only factor leading to depletion of cognitive functions. It is known that treatment with statins does not improve results in neuropsychological tests despite of favorable effect on cholesterol fraction concentration and anti-inflammatory effect [10]. Moreover, many investigations concerned elderly or patients with DM2.…”

Section: Discussionmentioning

confidence: 99%

Cognitive decline affects diabetic women

Perzyński

Chmiel-Perzyñska

2016

Current Problems of Psychiatry

View full text Add to dashboard Cite

Introduction: DM provokes peripheral complications and changes in central nervous system. Central changes in the course of diabetes mellitus (DM) include changes in brain tissue structure, electrophysiological abnormalities but also disturbances in neurotransmission leading to cognitive decline.Aim of the study: The aim of our study was to asses cognitive functioning of patients suffering from DM1 for at least 5 years but without any diagnosed complications. Results: We stated that women, compared with men, presented worsening of executive functions, speed and motor control. Cognitive decline depended on number of episodes of at least moderate hypoglycemia and duration of disease. HbA1c below 8% resulted in better memory, speed and motor control. Cognitive decline was more escalated in the patients with atherogenic lipid profile.Conclusions: It seems that even apparent lack of complications is not unambiguous with lack of cognitive decline and women seem to be more susceptible. DM1 affects young individuals, whose cognitive functions are in the course of the development, so it is important to find the underlying mechanisms and the areas of disturbed cognitive functioning and further investigations are needed.

show abstract

Statins for the prevention of dementia

Cited by 203 publications

References 100 publications

Do Statins Impair Cognition? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Do Statins Impair Cognition? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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

Cognitive decline affects diabetic women

Contact Info

Product

Resources

About