Question:

Is there a role for statins in the prevention of dementia?

9 January 2009

There appears considerable uncertainty on this topic.

In 2008 the JNNP published results of the large Rotterdam Study which followed 6992 participants for over ten years [1].  They reported the following results and conclusions:

“Results: During follow-up (mean 9 years), 582 persons developed AD. Compared with never use of cholesterol-lowering drugs, statin use was associated with a decreased risk of AD (HR 0.57; 95% CI 0.37 to 0.90), but non-statin cholesterol-lowering drug use was not (HR 1.05; 95% CI 0.45 to 2.44). HRs were equal for lipophilic (HR 0.54; 95% CI 0.32 to 0.89) and hydrophilic statins (HR 0.54; 95% CI 0.26 to 1.11).

Conclusion: In the general population, the use of statins, but not of non-statin cholesterol-lowering drugs, was associated with a lower risk of AD compared with never use of cholesterol-lowering drugs. The protective effect was independent of the lipophilicity of statins."

A 2007 record in the DARE database  “Prevention and treatment of dementia or Alzheimer's disease by statins: a meta-analysis” [2] concludes:

“This review concluded that current evidence does not show any beneficial preventive effects of statins on dementia or Alzheimer’s disease. Overall, the reviewers’ analysis supports their conclusions, but the reliability of the findings is unclear given the poor reporting of the review methods and the absence of any assessment of study quality.”

References

1) http://jnnp.bmj.com/cgi/content/abstract/80/1/13
2) http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12007000980

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