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Randomized Controlled Trial
. 2012 Aug;21(6):436-44.
doi: 10.1016/j.jstrokecerebrovasdis.2010.11.002. Epub 2011 Jan 14.

Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study

Kerstin Bettermann  1 , Alice M Arnold, Jeff Williamson, Stephen Rapp, Kaycee Sink, James F Toole, Michelle C Carlson, Sevil Yasar, Steven Dekosky, Gregory L Burke
Affiliations
Randomized Controlled Trial

Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study

Kerstin Bettermann et al. J Stroke Cerebrovasc Dis. 2012 Aug.

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.

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Figures

Figure 1
Figure 1
Proportion of participants taking statins and other lipid lowering medications by year. Circles=Statins; squares=Other LLM
Figure 2
Figure 2
Estimated survival curves for time to dementia in all participants Dashed line= No LLM; solid line=Statins; Dash-dot line= Other LLM.
See this image and copyright information in PMC

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