Use of Lipid-Lowering Agents, Indication Bias, and the Risk of Dementia in Community-Dwelling Elderly People

Abstract

While the possibility of indication bias in the original observations cannot be excluded, it was not demonstrated in LLA use in this study. Lipid-lowering agent use was associated with a lower risk of dementia, and specifically of Alzheimer disease, in those younger than 80 years. Further research is warranted.

Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity. The Rotterdam Study

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13.…”

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13. Important limitations of these studies included the limited durations of follow-up, as short as 3 years,12 and low number of incident Alzheimer cases 11 12.…”

Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity. The Rotterdam Study

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13.…”

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13. Important limitations of these studies included the limited durations of follow-up, as short as 3 years,12 and low number of incident Alzheimer cases 11 12.…”

Serum cholesterol and cognitive functions: the Lothian Birth Cohort 1936

“…Although initial analyses revealed some differences favoring non-statin users in terms of better cognitive function, adjusted analyses suggested that participants taking statins did not differ from their counterparts in terms of neuropsychological test performance. Our results are in line with another observational study (Benito-León et al , 2010) and several clinical trials (Trompet et al , 2010; see Xiong et al , 2005) reporting no cognitive effects of statin treatment in the elderly, but not with the many observational studies reporting beneficial effects (Rockwood et al , 2002; Yaffe et al , 2002; Bernick et al , 2005; Solomon et al , 2009). On the whole, longitudinal studies with long follow-up periods have failed to confirm these results (see Van Vliet et al , 2009) and a recent systematic review of randomized controlled trials, cohort case-control, and cross-sectional studies evaluating cognition in patients receiving statins concluded that statins have a neutral effect.…”

Statins, Risk of Dementia, and Cognitive Function: Secondary Analysis of the Ginkgo Evaluation of Memory Study

“…While some studies have been negative, others have shown a lower rate of dementia in individuals receiving statins (10–18). Similar to our results, a Canadian study found that the use of LLMs was associated with a lower risk of dementia, specifically AD (11) and in the recently published Rotterdam study, statin use was associated with lower risk of AD in the general population (16). …”

Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity. The Rotterdam Study

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13.…”

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13. Important limitations of these studies included the limited durations of follow-up, as short as 3 years,12 and low number of incident Alzheimer cases 11 12.…”

Serum cholesterol and cognitive functions: the Lothian Birth Cohort 1936

“…Although initial analyses revealed some differences favoring non-statin users in terms of better cognitive function, adjusted analyses suggested that participants taking statins did not differ from their counterparts in terms of neuropsychological test performance. Our results are in line with another observational study (Benito-León et al , 2010) and several clinical trials (Trompet et al , 2010; see Xiong et al , 2005) reporting no cognitive effects of statin treatment in the elderly, but not with the many observational studies reporting beneficial effects (Rockwood et al , 2002; Yaffe et al , 2002; Bernick et al , 2005; Solomon et al , 2009). On the whole, longitudinal studies with long follow-up periods have failed to confirm these results (see Van Vliet et al , 2009) and a recent systematic review of randomized controlled trials, cohort case-control, and cross-sectional studies evaluating cognition in patients receiving statins concluded that statins have a neutral effect.…”

Statins, Risk of Dementia, and Cognitive Function: Secondary Analysis of the Ginkgo Evaluation of Memory Study

“…While some studies have been negative, others have shown a lower rate of dementia in individuals receiving statins (10–18). Similar to our results, a Canadian study found that the use of LLMs was associated with a lower risk of dementia, specifically AD (11) and in the recently published Rotterdam study, statin use was associated with lower risk of AD in the general population (16). …”

Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity. The Rotterdam Study

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13.…”

“…Our findings are in line with the cross-sectional reports, which showed a lower prevalence of dementia among statin users 1 – 3. Most of the prospective studies did not find a protective effect of statins or only for persons younger than 80 years of age 3 7 – 10 12 13. Important limitations of these studies included the limited durations of follow-up, as short as 3 years,12 and low number of incident Alzheimer cases 11 12.…”

Serum cholesterol and cognitive functions: the Lothian Birth Cohort 1936

“…Although initial analyses revealed some differences favoring non-statin users in terms of better cognitive function, adjusted analyses suggested that participants taking statins did not differ from their counterparts in terms of neuropsychological test performance. Our results are in line with another observational study (Benito-León et al , 2010) and several clinical trials (Trompet et al , 2010; see Xiong et al , 2005) reporting no cognitive effects of statin treatment in the elderly, but not with the many observational studies reporting beneficial effects (Rockwood et al , 2002; Yaffe et al , 2002; Bernick et al , 2005; Solomon et al , 2009). On the whole, longitudinal studies with long follow-up periods have failed to confirm these results (see Van Vliet et al , 2009) and a recent systematic review of randomized controlled trials, cohort case-control, and cross-sectional studies evaluating cognition in patients receiving statins concluded that statins have a neutral effect.…”

Statins, Risk of Dementia, and Cognitive Function: Secondary Analysis of the Ginkgo Evaluation of Memory Study

“…While some studies have been negative, others have shown a lower rate of dementia in individuals receiving statins (10–18). Similar to our results, a Canadian study found that the use of LLMs was associated with a lower risk of dementia, specifically AD (11) and in the recently published Rotterdam study, statin use was associated with lower risk of AD in the general population (16). …”