Statins do not induce cognitive decline, dementia in older adults

Statin therapy does not appear to lead to incident dementia, mild cognitive impairment (MCI), or declines in individual cognitive domains among adults aged ≥65 years, according to a study.

A total of 18,846 participants ≥65 years of age in a randomized trial of aspirin, who had no prior cardiovascular events, major physical disability, or dementia initially were included in this analysis and followed for 4.7 years.

Measurement outcomes were as follows: incident dementia and its subclassifications (probable Alzheimer’s disease [AD], mixed presentations); MCI and its subclassifications (MCI consistent with AD, other MCI); and changes in domain-specific cognition, including global cognition, memory, language and executive function, psychomotor speed, and the composite of these domains.

The authors examined the associations of baseline statin use vs nonuse with dementia and MCI outcomes using Cox proportional hazards models and with cognitive change using linear mixed-effects models, adjusting for potential confounders. They further examined the impact of statin lipophilicity on these associations and identified effect modifiers.

The analysis revealed that the use of statins did not correlate with dementia, MCI, or their subclassifications or with changes in cognitive function scores over time (p>0.05 for all) compared with nonuse. In addition, outcomes were comparable between users of hydrophilic and lipophilic statins.

Of note, the associations of statins with dementia (p_interaction<0.001) and memory change (p_interaction=0.02) were modified by baseline neurocognitive ability.

“These findings await confirmation from ongoing randomized trials,” the authors said.