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Statin use and the risk of incident dementia: the Cardiovascular Health Study.
Arch Neurol 2005; 62(7):1047-51AN

Abstract

BACKGROUND

Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular risk through mechanisms that might affect the development of dementia.

OBJECTIVE

To evaluate whether statin use is associated with a lower risk of dementia compared with never use of lipid-lowering agents (LLAs).

DESIGN

Cohort study of community-dwelling adults 65 years and older. The analysis included 2798 participants free of dementia at baseline.

MAIN OUTCOME MEASURES

Using Cox proportional hazards regression analysis, we estimated the risk of incident all-cause and type-specific dementia associated with time-dependent statin therapy compared with never use of LLAs. The primary analyses incorporated a 1-year lag between exposure and outcome. Secondary analyses included the final year of exposure and modeled statin use as current use vs nonuse to simulate a case-control approach.

RESULTS

Compared with never use of LLAs, ever use of statins was not associated with the risk of all-cause dementia (multivariable-adjusted hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.77-1.52), Alzheimer disease alone (HR, 1.21; 95% CI, 0.76-1.91), mixed Alzheimer disease and vascular dementia (HR, 0.87; 95% CI, 0.44-1.72), or vascular dementia alone (HR, 1.36; 95% CI, 0.61-3.06). In contrast, in secondary analyses, current use of statins compared with nonuse of LLAs was associated with HRs of 0.69 (95% CI, 0.46-1.02) for all-cause dementia and 0.56 (95% CI, 0.35-0.92) for any Alzheimer disease.

CONCLUSIONS

In this cohort study, statin therapy was not associated with a decreased risk of dementia. Methodological differences may explain why results of this cohort investigation differ from those of prior case-control studies. Additional investigation is needed to determine whether and for whom statin use may affect dementia risk.

Authors+Show Affiliations

Department of Medicine, University of Washington, Seattle 98101, USA. rea123@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16009757

Citation

Rea, Thomas D., et al. "Statin Use and the Risk of Incident Dementia: the Cardiovascular Health Study." Archives of Neurology, vol. 62, no. 7, 2005, pp. 1047-51.
Rea TD, Breitner JC, Psaty BM, et al. Statin use and the risk of incident dementia: the Cardiovascular Health Study. Arch Neurol. 2005;62(7):1047-51.
Rea, T. D., Breitner, J. C., Psaty, B. M., Fitzpatrick, A. L., Lopez, O. L., Newman, A. B., ... Kuller, L. H. (2005). Statin use and the risk of incident dementia: the Cardiovascular Health Study. Archives of Neurology, 62(7), pp. 1047-51.
Rea TD, et al. Statin Use and the Risk of Incident Dementia: the Cardiovascular Health Study. Arch Neurol. 2005;62(7):1047-51. PubMed PMID: 16009757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin use and the risk of incident dementia: the Cardiovascular Health Study. AU - Rea,Thomas D, AU - Breitner,John C, AU - Psaty,Bruce M, AU - Fitzpatrick,Annette L, AU - Lopez,Oscar L, AU - Newman,Anne B, AU - Hazzard,William R, AU - Zandi,Peter P, AU - Burke,Gregory L, AU - Lyketsos,Constantine G, AU - Bernick,Charles, AU - Kuller,Lewis H, PY - 2005/7/13/pubmed PY - 2005/8/3/medline PY - 2005/7/13/entrez SP - 1047 EP - 51 JF - Archives of neurology JO - Arch. Neurol. VL - 62 IS - 7 N2 - BACKGROUND: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular risk through mechanisms that might affect the development of dementia. OBJECTIVE: To evaluate whether statin use is associated with a lower risk of dementia compared with never use of lipid-lowering agents (LLAs). DESIGN: Cohort study of community-dwelling adults 65 years and older. The analysis included 2798 participants free of dementia at baseline. MAIN OUTCOME MEASURES: Using Cox proportional hazards regression analysis, we estimated the risk of incident all-cause and type-specific dementia associated with time-dependent statin therapy compared with never use of LLAs. The primary analyses incorporated a 1-year lag between exposure and outcome. Secondary analyses included the final year of exposure and modeled statin use as current use vs nonuse to simulate a case-control approach. RESULTS: Compared with never use of LLAs, ever use of statins was not associated with the risk of all-cause dementia (multivariable-adjusted hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.77-1.52), Alzheimer disease alone (HR, 1.21; 95% CI, 0.76-1.91), mixed Alzheimer disease and vascular dementia (HR, 0.87; 95% CI, 0.44-1.72), or vascular dementia alone (HR, 1.36; 95% CI, 0.61-3.06). In contrast, in secondary analyses, current use of statins compared with nonuse of LLAs was associated with HRs of 0.69 (95% CI, 0.46-1.02) for all-cause dementia and 0.56 (95% CI, 0.35-0.92) for any Alzheimer disease. CONCLUSIONS: In this cohort study, statin therapy was not associated with a decreased risk of dementia. Methodological differences may explain why results of this cohort investigation differ from those of prior case-control studies. Additional investigation is needed to determine whether and for whom statin use may affect dementia risk. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/16009757/Statin_use_and_the_risk_of_incident_dementia:_the_Cardiovascular_Health_Study_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.62.7.1047 DB - PRIME DP - Unbound Medicine ER -