Association of blood lipids, atherosclerosis and statin use with dementia and cognitive impairment after stroke: A systematic review and meta-analysis

Yang, Zhirong; Wang, Hanyuying; Edwards, Duncan; Ding, Chengyuan; Li, Yan; Brayne, Carol; Mant, Jonathan

doi:10.1016/j.arr.2019.100962

Cited by 58 publications

(51 citation statements)

References 94 publications

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“…However, it is not clear whether the risk of dementia would also be increased in patients with stroke and prior ASCVD. A recent systematic review found that CHD and PAD were associated with dementia after stroke [13]. However, only two of the included studies provided adjusted estimates of the association, and there were other limitations of the included studies, including potential selection bias, small sample size, and lack of long-term follow-up (median of maximum follow-up: 0.5 year; interquartile range (IQR): 0.25 to 4 years) [13].…”

Section: Introductionmentioning

confidence: 99%

“…A recent systematic review found that CHD and PAD were associated with dementia after stroke [13]. However, only two of the included studies provided adjusted estimates of the association, and there were other limitations of the included studies, including potential selection bias, small sample size, and lack of long-term follow-up (median of maximum follow-up: 0.5 year; interquartile range (IQR): 0.25 to 4 years) [13]. The two studies [8,9] that adjusted for confounding only took into account demographic covariates and stroke severity but not other potential confounders of dementia, such as lifestyle, cardiovascular risk factors, co-morbidities and medications [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…The two studies [8,9] that adjusted for confounding only took into account demographic covariates and stroke severity but not other potential confounders of dementia, such as lifestyle, cardiovascular risk factors, co-morbidities and medications [10][11][12]. It is not clear whether the association might vary with age at first diagnosis of prior ASCVD, with duration of prior ASCVD, or in different patient subgroups [13]. Whether the association of atherosclerosis with dementia varies by vessel affected (e.g., coronary arteries or peripheral arteries) is not known for the general population [17], let alone in stroke patients [13].…”

Section: Introductionmentioning

confidence: 99%

“…It is not clear whether the association might vary with age at first diagnosis of prior ASCVD, with duration of prior ASCVD, or in different patient subgroups [13]. Whether the association of atherosclerosis with dementia varies by vessel affected (e.g., coronary arteries or peripheral arteries) is not known for the general population [17], let alone in stroke patients [13]. Understanding the roles of prior ASCVD in post-stroke dementia may help inform the monitoring and prevention strategies for dementia in these patients.…”

Section: Introductionmentioning

confidence: 99%

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Association of Prior Atherosclerotic Cardiovascular Disease with Dementia After Stroke: A Retrospective Cohort Study

Yang

Edwards

Burgess

et al. 2020

JAD

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Background: Prior atherosclerotic cardiovascular disease (ASCVD), including coronary heart disease (CHD) and peripheral artery disease (PAD), are common among patients with stroke, a known risk factor for dementia. However, whether these conditions further increase the risk of post-stroke dementia remains uncertain. Objective: To examine whether prior ASCVD is associated with increased risk of dementia among stroke patients. Methods: A retrospective cohort study was conducted using the Clinical Practice Research Datalink with linkage to hospital data. Patients with first-ever stroke between 2006 and 2017 were followed up to 10 years. We used multi-variable Cox regression models to examine the associations of prior ASCVD with dementia and the impact of prior ASCVD onset and duration. Results: Among 63,959 patients, 7,265 cases (11.4%) developed post-stroke dementia during a median of 3.6-year follow-up. The hazard ratio (HR) of dementia adjusted for demographics and lifestyle was 1.18 (95% CI: 1.12–1.25) for ASCVD, 1.16 (1.10–1.23) for CHD, and 1.25 (1.13–1.37) for PAD. The HRs additionally adjusted for multimorbidity and medications were 1.07 (1.00–1.13), 1.04 (0.98–1.11), and 1.11 (1.00–1.22), respectively. Based on the fully adjusted estimates, there was no linear relationship between the age of ASCVD onset and post-stroke dementia (all p-trend >0.05). The adjusted risk of dementia was not increased with the duration of pre-stroke ASCVD (all p-trend >0.05). Conclusion: Stroke patients with prior ASCVD are more likely to develop subsequent dementia. After full adjustment for confounding, however, the risk of post-stroke dementia is attenuated, with only a slight increase with prior ASCVD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of Prior Atherosclerotic Cardiovascular Disease with Dementia After Stroke: A Retrospective Cohort Study

Yang

Edwards

Burgess

et al. 2020

JAD

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“…Another negative impact of lovastatin is a cognitive impairment which particularly affecting memory [11,12]. On another note, lovastatin does not have impacts on cognitive functions [38].…”

Section: Discussionmentioning

confidence: 99%

Long-term Administration of Lovastatin and Rivastigmine: An In Vivo Evaluation on Cognitive Functions and Brain Acetylcholinesterase Activity

Badruddeen

Akhtar

Arif

et al. 2020

INNOSC Theranostics and Pharmacological Sciences

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Background. There is not much evidence illustrating that statins could be responsible for memory loss or dementia, although increased exposure to statins has been reported to cause cognitive side effects. The present study investigated the effect of lovastatin in combination with rivastigmine on cognitive function as well as brain acetylcholinesterase (AChE) activity in normal mice. Methods. The mice were categorized into four groups, and they were treated with normal saline, lovastatin, rivastigmine, and the combination of lovastatin and rivastigmine, respectively, by oral administration for 60 days. The treatment effect on cognitive functions was assessed by behavioral tests, namely, the passive avoidance test and spontaneous alternation test, as well as the measurement of brain AChE activity by Ellman’s method. Results. In this study, a significant reduction (P < 0.01) of brain AChE activity and positive effects (P < 0.01) on cognitive functions was observed in mice treated with the combination of lovastatin and rivastigmine as compared to rivastigmine alone. However, no significant differences (P < 0.05) were observed on brain AChE activity as well as cognitive functions in mice treated with lovastatin when compared with those treated with normal saline. Conclusion. This study suggested that lovastatin did not contribute to any improvements in cognitive functions and brain AChE activity, but it potentiated the effect of rivastigmine.

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The chronic neuropsychiatric sequelae of COVID‐19: The need for a prospective study of viral impact on brain functioning

Erausquin

Snyder

Carrillo

et al. 2021

Alzheimer's & Dementia

173

154

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Introduction:The increasing evidence of SARS-CoV-2 impact on the central nervous system (CNS) raises key questions on its impact for risk of later life cognitive decline, Alzheimer's disease (AD), and other dementia.Methods: The Alzheimer's Association and representatives from more than 30 countries-with technical guidance from the World Health Organization-have formed an international consortium to study the short-and long-term consequences of SARS-CoV-2 on the CNS-including the underlying biology that may contribute to AD and other dementias. This consortium will link teams from around the world covering more than 22 million COVID-19 cases to enroll two groups of individuals including people with disease, to be evaluated for follow-up evaluations at 6, 9, and 18 months, and people who are already enrolled in existing international research studies to add additional measures and markers of their underlying biology. Conclusions:The increasing evidence and understanding of SARS-CoV-2's impact on the CNS raises key questions on the impact for risk of later life cognitive decline, AD, and other dementia. This program of studies aims to better understand the long-term consequences that may impact the brain, cognition, and functioning-including the underlying biology that may contribute to AD and other dementias.

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Association of blood lipids, atherosclerosis and statin use with dementia and cognitive impairment after stroke: A systematic review and meta-analysis

Cited by 58 publications

References 94 publications

Association of Prior Atherosclerotic Cardiovascular Disease with Dementia After Stroke: A Retrospective Cohort Study

Association of Prior Atherosclerotic Cardiovascular Disease with Dementia After Stroke: A Retrospective Cohort Study

Long-term Administration of Lovastatin and Rivastigmine: An In Vivo Evaluation on Cognitive Functions and Brain Acetylcholinesterase Activity

The chronic neuropsychiatric sequelae of COVID‐19: The need for a prospective study of viral impact on brain functioning

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