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Observational Study
. 2020 May;28(5):507-517.
doi: 10.1016/j.jagp.2019.11.003. Epub 2019 Nov 11.

Statin Use and Risk of Cognitive Decline in the ADNI Cohort

Emily C Kemp  1 , Megan K Ebner  2 , Srinath Ramanan  2 , Tyler A Godek  2 , Erika A Pugh  2 , Hugh H Bartlett  2 , Julia W McDonald  2 , Marcia C Mecca  3 , Christopher H van Dyck  4 , Adam P Mecca  2 ; Alzheimer's Disease Neuroimaging Initiative
Affiliations
Observational Study

Statin Use and Risk of Cognitive Decline in the ADNI Cohort

Emily C Kemp et al. Am J Geriatr Psychiatry. 2020 May.

Abstract

Objective: To investigate associations between statin use and cognitive change, as well as diagnostic conversion, in individuals with cognitively normal (CN) status, mild cognitive impairment (MCI), and dementia due to Alzheimer disease (AD-dementia).

Methods: A multicenter cohort study with 1629 adults 48 to 91 years old with CN status, early MCI (EMCI), late MCI (LMCI), or AD-dementia at baseline followed prospectively for 24 months. Statin use was assessed at baseline, and cognition was measured over time with a composite memory score, a composite executive function score, and a global cognition score (Alzheimer's Disease Assessment Scale). Conversion to a more impaired diagnostic category was determined by clinician assessment. Repeated measures linear mixed-effects models were used to evaluate associations between statin use and change in cognition over time. Cox proportional hazards models were used to evaluate associations between statin use and time to diagnostic conversion. All models were stratified by baseline diagnostic group.

Results: Statin use was not associated with change in cognitive measures for CN, LMCI, or AD-dementia participants. Among EMCI participants, statin use was associated with a significantly slower rate of decline on the memory composite, but no other cognitive measure. Statin use was not associated with time to conversion for any diagnostic group.

Conclusions: This study did not support an association between statin use and diagnostic conversion but suggested a possible association between statin use and cognitive change in EMCI. Additional randomized clinical trials of statins may be warranted in the prodromal EMCI stage of AD.

Keywords: ADNI; Alzheimer's Disease; executive function; memory; statin.

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Conflict of interest statement

Disclosures

None of the authors have actual or potential conflicts of interest to disclose that are related to this research.

Figures

Figure 1:
Figure 1:. Change in cognition over time for statin users and nonusers.
Memory (ADNI-Mem), executive function (ADNI-EF), and global cognition (ADAS-11) over time for statin users and nonusers stratified by baseline diagnosis of cognitively normal (CN), early MCI (EMCI), late MCI (LMCI), or dementia due to AD (AD-dementia). Repeated measures linear mixed effects models were used to test associations between statin use and change in cognitive outcome over time. Plotted values are unadjusted means with error bars for standard error of the mean.
Figure 2:
Figure 2:. Conversion to a more impaired diagnostic category.
Survival curves were constructed using the Kaplan-Meier method.
See this image and copyright information in PMC

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