Title | Statin use and the risk of incident dementia: the Cardiovascular Health Study. |
Publication Type | Journal Article |
Year of Publication | 2005 |
Authors | Rea, TD, Breitner, JC, Psaty, BM, Fitzpatrick, AL, Lopez, OL, Newman, AB, Hazzard, WR, Zandi, PP, Burke, GL, Lyketsos, CG, Bernick, C, Kuller, LH |
Journal | Arch Neurol |
Volume | 62 |
Issue | 7 |
Pagination | 1047-51 |
Date Published | 2005 Jul |
ISSN | 0003-9942 |
Keywords | Aged, Aged, 80 and over, Cardiovascular Diseases, Cohort Studies, Dementia, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hyperlipidemias, Male |
Abstract | <p><b>BACKGROUND: </b>Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular risk through mechanisms that might affect the development of dementia.</p><p><b>OBJECTIVE: </b>To evaluate whether statin use is associated with a lower risk of dementia compared with never use of lipid-lowering agents (LLAs).</p><p><b>DESIGN: </b>Cohort study of community-dwelling adults 65 years and older. The analysis included 2798 participants free of dementia at baseline.</p><p><b>MAIN OUTCOME MEASURES: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
DOI | 10.1001/archneur.62.7.1047 |
Alternate Journal | Arch Neurol |
PubMed ID | 16009757 |
Grant List | N01 HC58079 / HC / NHLBI NIH HHS / United States N01 HC58082 / HC / NHLBI NIH HHS / United States N01 HC58083 / HC / NHLBI NIH HHS / United States N01 HC58084 / HC / NHLBI NIH HHS / United States N01 HC58085 / HC / NHLBI NIH HHS / United States N01 HC58086 / HC / NHLBI NIH HHS / United States N01 HC85080 / HC / NHLBI NIH HHS / United States N01 HC85081 / HC / NHLBI NIH HHS / United States N01 HL15103 / HL / NHLBI NIH HHS / United States N01 HL35129 / HL / NHLBI NIH HHS / United States R01 625566 / / PHS HHS / United States R01 AG09556 / AG / NIA NIH HHS / United States R01 AG15928 / AG / NIA NIH HHS / United States |