Journal article
Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults
Journal of the American College of Cardiology, Vol.77(25), pp.3145-3156
06/29/2021
DOI: 10.1016/j.jacc.2021.04.075
PMCID: PMC8091356
PMID: 34167639
Abstract
BACKGROUND The neurocognitive effect of statins in older adults remain uncertain.
OBJECTIVES The aim of this study was to investigate the associations of statin use with cognitive decline and incident dementia among older adults.
METHODS This analysis included 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 and were followed for 4.7 years. Outcome measures included incident dementia and its subclassifications (probable Alzheimer's disease, mixed presentations); mild cognitive impairment (MCI) and its subclassifications (MCI consistent with Alzheimer's disease, other MCI); and changes in domain-specific cognition, including global cognition, memory, language and executive function, psychomotor speed, and the composite of these domains. Associations of baseline statin use versus nonuse with dementia and MCI outcomes were examined using Cox proportional hazards models and with cognitive change using linear mixed-effects models, adjusting for potential confounders. The impact of statin lipophilicity on these associations was further examined, and effect modifiers were identified.
RESULTS Statin use versus nonuse was not associated with dementia, MCI, or their subclassifications or with changes in cognitive function scores over time (p > 0.05 for all). No differences were found in any outcomes between hydrophilic and lipophilic statin users. Baseline neurocognitive ability was an effect modifier for the associations of statins with dementia (p for interaction < 0.001) and memory change (p for interaction = 0.02).
CONCLUSIONS In adults >= 65 years of age, statin therapy was not associated with incident dementia, MCI, or declines in individual cognition domains. These findings await confirmation from ongoing randomized trials. (J Am Coll Cardiol 2021;77:3145-56) (C) 2021 by the American College of Cardiology Foundation.
Details
- Title: Subtitle
- Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults
- Creators
- Zhen Zhou - Menzies Research InstituteJoanne Ryan - Monash UniversityMichael E. Ernst - Roy J. and Lucille A. Carver College of MedicineSophia Zoungas - Monash UniversityAndrew M. Tonkin - Monash UniversityRobyn L. Woods - Monash UniversityJohn J. McNeil - Monash UniversityChristopher M. Reid - Curtin UniversityAndrea J. Curtis - Monash UniversityRory Wolfe - Monash UniversityJo Wrigglesworth - Monash UniversityRaj C. Shah - Rush University Medical CenterElsdon Storey - Monash UniversityAnne Murray - University of MinnesotaSuzanne G. Orchard - Monash UniversityMark R. Nelson - Menzies Research InstituteASPREE Investigator Group
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Cardiology, Vol.77(25), pp.3145-3156
- Publisher
- Elsevier
- DOI
- 10.1016/j.jacc.2021.04.075
- PMID
- 34167639
- PMCID
- PMC8091356
- ISSN
- 0735-1097
- eISSN
- 1558-3597
- Number of pages
- 12
- Grant note
- DOI: 10.13039/100002429, name: Amgen; DOI: 10.13039/501100001779, name: Monash University; DOI: 10.13039/100004319, name: Pfizer; DOI: 10.13039/501100021515, name: Sanofi Australia; DOI: 10.13039/100004326, name: Bayer; DOI: 10.13039/100004334, name: Merck; DOI: 10.13039/100000054, name: National Cancer Institute; DOI: 10.13039/501100000925, name: National Health and Medical Research Council; DOI: 10.13039/100000002, name: National Institutes of Health, award: 1127060, 334047; DOI: 10.13039/100000049, name: National Institute on Aging; DOI: 10.13039/100008018, name: Victorian Cancer Agency
- Language
- English
- Date published
- 06/29/2021
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297337402771
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