Effect of Pharmacologic Lipid Lowering on Health‐Related Quality of Life in Older Persons: Results from the Cholesterol Reduction in Seniors Program (CRISP) Pilot Study

Santanello, Nancy C.; Barber, Beth; Applegate, William B.; Elam, Janet T.; Curtis, Carolyn; Hunninghake, Donald B.; Gordon, David

doi:10.1111/j.1532-5415.1997.tb00971.x

Cited by 97 publications

(46 citation statements)

References 26 publications

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“…After adjusting for potential confounders, including medications with central nervous effects and premorbid intelligence, participants taking statins did not differ from their untreated counterparts in the performance of formal neuropsychological tests. Our results are in line with two placebo-controlled trials of statin treatment in the elderly [13,14]. Antidepressants, anxiolytics, stimulants, antihypertensives, antiepileptics, or antihistamines can affect psychomotor functioning, concentration, and memory [15].…”

Section: Discussionsupporting

confidence: 72%

“…Therefore, selection factors may have influenced the findings of the clinical trials [6][7][8]. In addition, unmeasured confounders, including medications that potentially affect cognitive function (e.g., anxiolytics, stimulants, antipsychotics, antidepressants, antihistamines, or antiepileptics drugs) [15] may have influenced the results of previous clinical trials [6,8,12,13] and community or population-based surveys outcomes [9][10][11]. We conducted a cross-sectional study of cognitive function in people treated with statins in a population-based elderly Spanish cohort.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, one randomized clinical trial has showed that statins may cause detrimental effects on cognitive performance in hypercholesterolemic adults aged 35-70 years [12]. In addition, cognitive function was unaffected in the elderly in two placebo-controlled trials of statin treatment [13,14]. In all but three of these previous studies, participants were ascertained through clinical trials [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Statins and Cognitive Functioning in the Elderly: A Population-Based Study

Benito-León

Louis

Vega³

et al. 2010

JAD

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Abstract. In a 2009 Cochrane review, the authors concluded that there is good evidence that statins, given in late life to people at risk of vascular disease, have no effect in preventing Alzheimer's disease or dementia. A related issue, which remains unclear, is whether statins improve cognitive function. While some studies have shown a beneficial effect of statins on cognitive function, others have observed mild detrimental effects on cognition. Our aim was to assess cognitive function in community-dwelling elderly participants treated with statins compared with their untreated counterparts (i.e., controls) living in the same population. 137 population-dwelling participants who were receiving statins and 411 matched controls age 65 years (median = 72 years) in central Spain (the Neurological Disorders in Central Spain [NEDICES] study) underwent a neuropsychological assessment, including tests of global cognitive performance, frontal-executive function, verbal fluency, and memory. Median duration of statin treatment was 2 years. Of 137 participants receiving statins, 53 (38.7%) were taking pravastatin, 38 (27.7%) simvastatin, 37 (27.0%) lovastatin, 6 (4.4%) fluvastatin, and 3 (2.2%) atorvastatin. Although initial univariate analyses indicated some differences, after adjusting for age, gender, education, depressive symptoms, premorbid intelligence, medications that potentially affect cognitive function, and blood cholesterol levels, statin users and controls performed similarly on all neuropsychological tests. In this population-based sample, elderly participants treated with statins and untreated controls performed similarly in all tested cognitive areas. These results do not support a positive benefit of statins on cognition.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Statins and Cognitive Functioning in the Elderly: A Population-Based Study

Benito-León

Louis

Vega³

et al. 2010

JAD

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“…[12][13][14][15] All had placebo rather than standard care comparators. RCTs (reported in 23 publications [13][14][15][36][37][38][39][40][41][42][43][44][45][46][47][48][50][51][52]55,56,62,64 ) enrolled subjects with normal cognition at baseline, four RCTs (reported in seven publications 12,54,[57][58][59][60][61] ) enrolled patients with AD, and three RCTs enrolled other cognitively impaired subjects (traumatic brain injury, 53,63 and neurofibromatosis type 1 49 ). Simvastatin (eight trials), pravastatin (eight trials), and lovastatin (six trials) were most frequently utilized in the statin RCTs.…”

Section: Assessment Of Heterogeneity and Meta-regression Analysesmentioning

confidence: 99%

Do Statins Impair Cognition? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2015

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BACKGROUND:In 2012, the United States Food and Drug Administration (FDA) issued a warning regarding potential adverse effects of HMG-CoA reductase inhibitors (statins) on cognition, based on the Adverse Events Reporting System and a review of the medical literature. We aimed to synthesize randomized clinical trial (RCTs) evidence on the association between statin therapy and cognitive outcomes. METHODS: We searched MEDLINE, EMBASE, and Cochrane CENTRAL through December 2012, and reviewed published systematic reviews of statin treatment. We sought RCTs that compared statin treatment versus placebo or standard care, and reported at least one cognitive outcome (frequency of adverse cognitive events or measurements using standard neuropsychological cognitive test scores). Studies reporting sufficient information to calculate effect sizes were included in metaanalyses. Standardized and unstandardized mean differences were calculated for continuous outcomes for global cognition and for pre-specified cognitive domains. The main outcome was change in cognition measured by neuropsychological tests; an outcome of secondary interest was the frequency of adverse cognitive events observed during follow-up. RESULTS: We identified 25 RCTs (all placebo-controlled) reporting cognitive outcomes in 46,836 subjects, of which 23 RCTs reported cognitive test results in 29,012 participants. Adverse cognitive outcomes attributable to statins were rarely reported in trials involving cognitively normal or impaired subjects. Furthermore, meta-analysis of cognitive test data (14 studies; 27,643 participants) failed to show significant adverse effects of statins on all tests of cognition in either cognitively normal subjects (standardized mean difference 0.01, 95 % confidence interval, CI, −0.01 to 0.03, p=0.42) or Alzheimer's disease subjects (standardized mean difference −0.05, 95 % CI −0.19 to 0.10, p=0.38). CONCLUSIONS: Statin therapy was not associated with cognitive impairment in RCTs. These results raise questions regarding the continued merit of the FDA warning about potential adverse effects of statins on cognition.

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“…Randomized trials with lovastatin [40], simvastatin [41], and pravastatin [42] have examined cognitive decline as a secondary endpoint and have failed to find any evidence of a protective effect of these statins on Alzheimer's dementia. However, a recent trial with atorvastatin observed positive results in a small number of elderly patients evaluated before and 1 year after exposure to 80 mg/d of atorvastatin [43].…”

Section: Central Nervous Systemmentioning

confidence: 99%

Other than potency, are all statins the same?

Abate

Chandalia²

2006

Curr Atheroscler Rep

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Statins have been shown to interact with metabolic pathways that potentially affect physiologic functions beyond cholesterol balance. We may broadly categorize non-lipid effects of statins as clinically favorable or clinically detrimental. Whether non-lipid effects of statins are of clinical significance and whether there are differences in non-lipid effects among statins remain points of major current controversy. This review evaluates the available information on potential differences among statins in non-lipid effects.

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Effect of Pharmacologic Lipid Lowering on Health‐Related Quality of Life in Older Persons: Results from the Cholesterol Reduction in Seniors Program (CRISP) Pilot Study

Abstract: This study demonstrates that lovastatin was extremely well tolerated in an older cohort, both with regard to symptoms and to health-related quality of life.

Cited by 97 publications

References 26 publications

Statins and Cognitive Functioning in the Elderly: A Population-Based Study

Statins and Cognitive Functioning in the Elderly: A Population-Based Study

Do Statins Impair Cognition? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Other than potency, are all statins the same?

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