Statin treatment not connected with cognitive decrease, dementia in older grownups, research study states.
Observational research study contributes to growing proof that statin treatment is not connected with cognitive decrease and dementia in older grownups, however randomized trials are still required.
The usage of statin treatment in grownups 65 years of ages or older is not connected with event dementia, moderate cognitive problems (MCI), or decrease in private cognition domains, according to a research study released in the Journal of the American College of Cardiology (JACC).
Cognitive decrease and dementia are significant health issues in older people, impacting about 10% of individuals over 60 years of ages. Statins are utilized to minimize low-density lipoprotein cholesterol, or bad cholesterol, hence they are an essential treatment for avoidance of main and secondary heart disease (CVD) occasions. The Food and Drug Administration launched a caution in 2012 about cases of obvious short-term cognitive problems with statin usage, while acknowledging that the cardiovascular advantages exceed their dangers.
However, organized evaluations have actually revealed inadequate proof on the effect of statins and research study has actually revealed blended outcomes, with some revealing a neurocognitive advantage of statins and others reporting a null impact. According to the scientists of this research study, because statins are extensively utilized amongst older grownups and anticipated to increase in usage, figuring out the impacts of statin treatment on cognition in older people is essential to assist clinicians weigh their advantages versus associated dangers.
“With statins being increasingly prescribed to older adults, their potential long-term effects on cognitive decline and dementia risk have attracted growing interest,” stated Zhen Zhou, PhD, Menzies Institute for Medical Research at the University of Tasmania in Australia and lead author of the research study. “The present study adds to previous research by suggesting that statin use at baseline was not associated with subsequent dementia incidence and long-term cognitive decline in older adults.”
Researchers of this research study evaluated information from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. ASPREE was a big potential, randomized placebo-controlled trial of everyday low-dose aspirin, that included 19,114 individuals 65 years of ages or older without any previous CVD occasion, dementia or significant handicap, in between 2010 and 2014 from Australia and the U.S. One of the crucial choice requirements of ASPREE was that individuals needed to have a rating of <78 for the Modified Mini-Mental State Examination test, a screening test for cognitive abilities, at enrollment.
Researchers excluded participants with missing values for cognitive test scores and/or covariates at baseline, resulting in 18,846 participants. They were grouped by their baseline statin use versus non-statin use, with 5,898 (31.3%) of participants taking statins. The study aimed to measure outcomes including incident dementia and its subclassifications (probable Alzheimer’s disease [AD], mixed presentations); MCI and its subclassifications (MCI consistent with AD, MCI-other); changes in domain-specific cognition including global cognition, memory, language, and executive function, and psychomotor speed; and in the composite of these domains.
After a median of 4.7 years of follow-up, researchers found 566 incident cases of dementia (including probable AD and mixed presentations). Compared with no statin use, statin use was not associated with risk of all-cause dementia, probable AD, or mixed presentations of dementia. There were 380 incident cases of MCI found (including MCI consistent with AD and MCI-other).
Compared to no statin use, statin use was not associated with risk of MCI, MCI consistent with AD or other MCI. There was no statistically significant difference in the change of composite cognition and any individual cognitive domains between statin users versus non-statin users. Also, no significant differences were found in any of the outcomes of interest between users of hydrophilic and lipophilic statins. However, researchers did find interaction effects between baseline cognitive ability and statin therapy for all dementia outcomes.
According to the researchers, this study has several limitations, including observational study bias, lack of data on the length of prior use of statins, and the dose of statins was not recorded in the ASPREE trial, so their effects could not be fully explored. Researchers conclude the study must be interpreted with caution and will require confirmation by randomized clinical trials designed to explore the neurocognitive effects of statins in older populations.
In an accompanying editorial comment, Christie M. Ballantyne, MD, professor at Baylor College of Medicine in Houston, said the study does have limitations that the authors address, but agreed the findings suggest statins do not contribute to cognitive decline.
“Overall, the analysis was well done, and its main strengths are a large cohort with a battery of standardized tests that allowed the investigators to track both cognition and incidence of dementia and its subtypes over time,” Ballantyne said. “Lingering questions such as the one raised by this analysis regarding potential adverse effects of statins in individuals with mildly impaired cognition can only be answered in randomized controlled trials in the appropriate age group and population and with appropriate testing and adequate follow-up. In the meantime, practicing clinicians can have confidence and share with their patients that short-term lipid lowering therapy in older individuals, including with statins, is unlikely to have a major impact on cognition.”
Reference: 21 June 2021, Journal of the American College of Cardiology.
DOI: 10.1016/j.jacc.2021.04.075
