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Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study.
J Stroke Cerebrovasc Dis 2012; 21(6):436-44JS

Abstract

BACKGROUND

Lipid-lowering medications (LLMs) and especially statin drugs can delay cognitive decline and dementia onset in individuals with and without mild cognitive impairment (MCI) at baseline.

METHODS

A longitudinal, observational study was conducted of 3069 cognitively healthy elderly patients (≥75 years of age) who were enrolled in the Ginkgo Evaluation of Memory Study. The primary outcome measure was the time to adjudicated all-cause dementia and Alzheimer dementia (AD). The secondary outcome measure was the change in global cognitive function over time measured by scores from the Modified Mini-Mental State Exam (3MSE) and the cognitive subscale of the AD Assessment Scale (ADAS-Cog).

RESULTS

Among participants without MCI at baseline, the current use of statins was consistently associated with a reduced risk of all-cause dementia (hazard ratio [HR], 0.79; 95% confidence interval [95% CI], 0.65-0.96; P = .021) and AD (HR, 0.57; 95% CI, 0.39-0.85; P = .005). In participants who initiated statin therapy, lipophilic statins tended to reduce dementia risk more than nonlipophilic agents. In contrast, there was no significant association between LLM use (including statins), dementia onset, or cognitive decline in individuals with baseline MCI. However, in individuals without MCI at baseline, there was a trend for a neuroprotective effect of statins on cognitive decline.

CONCLUSIONS

Statins may slow the rate of cognitive decline and delay the onset of AD and all-cause dementia in cognitively healthy elderly individuals, whereas individuals with MCI may not have comparable cognitive protection from these agents. However, the results from this observational study need to be interpreted with caution and will require confirmation by randomized clinical trials stratifying treatment groups based on MCI status at baseline.

Authors+Show Affiliations

Department of Neurology, Penn State College of Medicine, Hershey, Pennsylvania, USA. kbettermann@hmc.psu.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 available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21236699

Citation

Bettermann, Kerstin, et al. "Statins, Risk of Dementia, and Cognitive Function: Secondary Analysis of the Ginkgo Evaluation of Memory Study." Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, vol. 21, no. 6, 2012, pp. 436-44.
Bettermann K, Arnold AM, Williamson J, et al. Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study. J Stroke Cerebrovasc Dis. 2012;21(6):436-44.
Bettermann, K., Arnold, A. M., Williamson, J., Rapp, S., Sink, K., Toole, J. F., ... Burke, G. L. (2012). Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study. Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, 21(6), pp. 436-44. doi:10.1016/j.jstrokecerebrovasdis.2010.11.002.
Bettermann K, et al. Statins, Risk of Dementia, and Cognitive Function: Secondary Analysis of the Ginkgo Evaluation of Memory Study. J Stroke Cerebrovasc Dis. 2012;21(6):436-44. PubMed PMID: 21236699.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study. AU - Bettermann,Kerstin, AU - Arnold,Alice M, AU - Williamson,Jeff, AU - Rapp,Stephen, AU - Sink,Kaycee, AU - Toole,James F, AU - Carlson,Michelle C, AU - Yasar,Sevil, AU - Dekosky,Steven, AU - Burke,Gregory L, Y1 - 2011/01/14/ PY - 2010/09/10/received PY - 2010/10/26/revised PY - 2010/11/07/accepted PY - 2011/1/18/entrez PY - 2011/1/18/pubmed PY - 2012/12/12/medline SP - 436 EP - 44 JF - Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association JO - J Stroke Cerebrovasc Dis VL - 21 IS - 6 N2 - BACKGROUND: Lipid-lowering medications (LLMs) and especially statin drugs can delay cognitive decline and dementia onset in individuals with and without mild cognitive impairment (MCI) at baseline. METHODS: A longitudinal, observational study was conducted of 3069 cognitively healthy elderly patients (≥75 years of age) who were enrolled in the Ginkgo Evaluation of Memory Study. The primary outcome measure was the time to adjudicated all-cause dementia and Alzheimer dementia (AD). The secondary outcome measure was the change in global cognitive function over time measured by scores from the Modified Mini-Mental State Exam (3MSE) and the cognitive subscale of the AD Assessment Scale (ADAS-Cog). RESULTS: Among participants without MCI at baseline, the current use of statins was consistently associated with a reduced risk of all-cause dementia (hazard ratio [HR], 0.79; 95% confidence interval [95% CI], 0.65-0.96; P = .021) and AD (HR, 0.57; 95% CI, 0.39-0.85; P = .005). In participants who initiated statin therapy, lipophilic statins tended to reduce dementia risk more than nonlipophilic agents. In contrast, there was no significant association between LLM use (including statins), dementia onset, or cognitive decline in individuals with baseline MCI. However, in individuals without MCI at baseline, there was a trend for a neuroprotective effect of statins on cognitive decline. CONCLUSIONS: Statins may slow the rate of cognitive decline and delay the onset of AD and all-cause dementia in cognitively healthy elderly individuals, whereas individuals with MCI may not have comparable cognitive protection from these agents. However, the results from this observational study need to be interpreted with caution and will require confirmation by randomized clinical trials stratifying treatment groups based on MCI status at baseline. SN - 1532-8511 UR - https://www.unboundmedicine.com/medline/citation/21236699/Statins_risk_of_dementia_and_cognitive_function:_secondary_analysis_of_the_ginkgo_evaluation_of_memory_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1052-3057(10)00253-3 DB - PRIME DP - Unbound Medicine ER -