Serum Cholesterol and Cerebrospinal Fluid Amyloid β Protein in Alzheimer'S Disease

Okamura, Nobuyuki; Arai, Hiroyuki; Maruyama, Masahiro; Matsui, Toshifumi; Tanji, Haruko; Sasaki, Hidetada; Yoshida, Hiroshi; Sugita, Mitsunori

doi:10.1046/j.1532-5415.2001.49293.x

Cited by 7 publications

(2 citation statements)

References 5 publications

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“…Besides increasing the risk of cardiovascular disease with subsequent increased risks of cognitive decline, high cholesterol levels might also directly influence the risk of cognitive decline. High total serum cholesterol levels have been shown to associate with lower cerebral spinal fluid levels of b-amyloid and larger amounts of b-amyloid deposition in brain autopsy studies [9,10].…”

Section: Introductionmentioning

confidence: 99%

Pravastatin and cognitive function in the elderly. Results of the PROSPER study

et al. 2009

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Observational studies have given conflicting results about the effect of statins in preventing dementia and cognitive decline. Moreover, observational studies are subject to prescription bias, making it hard to draw definite conclusions from them. Randomized controlled trials are therefore the preferred study design to investigate the association between statins and cognition. Here we present detailed cognitive outcomes from the randomized placebocontrolled PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). Cognitive function was assessed repeatedly in all 5,804 PROSPER participants at six different time points during the study using four neuropsychological performance tests. After a mean follow-up period of 42 months, no difference in cognitive decline at any of the cognitive domains was found in subjects treated with pravastatin compared to placebo (all p [ 0.05). Pravastatin treatment in old age did not affect cognitive decline during a 3 year follow-up period. Employing statin therapy in the elderly in an attempt to prevent cognitive decline therefore seems to be futile.

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Section: Introductionmentioning

confidence: 99%

Pravastatin and cognitive function in the elderly. Results of the PROSPER study

et al. 2009

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“…31 Statins could protect the brain by reducing the risk of vascular disease and strokes, but could also exert a direct effect, as high serum cholesterol has been shown to associate with lower levels of β-amyloid in the cerebrospinal fluid and more β-amyloid deposition in the brain. 32,33 Many cross-sectional and case-control studies have found improved cognitive outcomes in statin-treated patients. [34][35][36][37] However, other studies, especially those of longer duration, have failed to confirm these results.…”

Section: Cognitive Functionmentioning

confidence: 99%

Statin therapy for the octogenarian?

Blom

2012

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Cardiovascular risk increases progressively with age. Statins in octogenarians may therefore potentially bring about large reductions in absolute risk. Epidemiological studies, however, show that statin prescription declines with age and is lowest in the oldest patients with the highest cardiovascular risk. Reasons for low statin utilisation in the elderly include safety concerns, doubts about the utility of statin therapy in those of advanced age and a paucity of definite trial evidence supporting statin prescription in octogenarians. Some of the more recently completed statin outcome trials have randomised patients as old as 82 years. A meta-analysis of secondary prevention, with patients aged 65-82 years at randomisation, supported statin prescription in this age group, as statin therapy was associated with relative risk reduction similar to that observed in younger patients. A Swedish registry study showed improved survival in octogenarians prescribed a statin following hospitalisation with an acute myocardial infarction. Currently there is no definite evidence that statin therapy prevents or ameliorates cognitive impairment or dementia. Statin therapy should be considered in octogenarians at high cardiovascular risk, taking into account factors such as biological vs. chronological age, life expectancy, quality of life, risk of interaction with medications taken for co-morbidities and the ability of the patient to take the statin safely.Peer reviewed.

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