Statin use in dementia—Review and comparison of guideline recommendations

Lech, Sonia; O’Sullivan, Julie Lorraine; Romanescu, Laura; Nordheim, Johanna; Gellert, Paul; Kuhlmey, Adelheid; Yaşar, Sevil

doi:10.1002/gps.5653

Cited by 3 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…SVD is responsible for a myriad of diseases; however, it is the most common cause of VaD (Figure 3). Although there are no established treatments for SVD, lowering a patient's blood pressure is a promising preventative measure [91]. Lastly, in conjunction with vascular health, statins have been implicated as a prophylactic treatment.…”

Section: Pharmaceutical Interventionsmentioning

confidence: 99%

Investigation into the vascular contributors to dementia and the associated treatments

Davidson,

Woodford,

Mathur

et al. 2023

Explor Neurosci

View full text Add to dashboard Cite

As the average lifespan has increased, memory disorders have become a more pressing public health concern. However, dementia in the elderly population is often neglected in light of other health priorities. Therefore, expanding the knowledge surrounding the pathology of dementia will allow more informed decision-making regarding treatment within elderly and older adult populations. An important emerging avenue in dementia research is understanding the vascular contributors to dementia. This review summarizes potential causes of vascular cognitive impairment like stroke, microinfarction, hypertension, atherosclerosis, blood-brain-barrier dysfunction, and cerebral amyloid angiopathy. Also, this review address treatments that target these vascular impairments that also show promising results in reducing patient’s risk for and experience of dementia.

show abstract

Section: Pharmaceutical Interventionsmentioning

confidence: 99%

Investigation into the vascular contributors to dementia and the associated treatments

Davidson,

Woodford,

Mathur

et al. 2023

Explor Neurosci

View full text Add to dashboard Cite

show abstract

“…Interestingly, some data suggest that a potential neurocognitively protective effect of statins may not necessarily be LDL-C dependent [90], although it is possibly statin intensity-dependent [91,92], rather implicating the pleiotropic and/or anti-inflammatory properties of statins. While most guidelines do not yet specifically endorse statin use for dementia prevention [93,94], these concepts should be kept at the forefront of risk-benefit discussions between clinicians and older adults contemplating alterations in statin therapy. Importantly, the ongoing Pragmatic Evaluation of Events And Benefits of Lipid-lowering in Older Adults (PREVENTABLE) trial involving the randomization of community-dwelling older (≥75 years) adults to atorvastatin 40 mg vs. placebo will specifically assess the primary endpoints of new dementia and chronic disability, which will offer high-quality evidence to help guide obligately individualized and nuanced statin therapeutic decisions in older individuals [95].…”

Section: Concerns and Special Considerations For Ascvd Risk Reduction...mentioning

confidence: 99%

Lipid-Targeted Atherosclerotic Risk Reduction in Older Adults: A Review

2022

View full text Add to dashboard Cite

Aggressive lipid-lowering lifestyle modifications and pharmacologic therapies are the cornerstones of the primary and secondary prevention of atherosclerotic cardiovascular disease events. While statins are highly effective, inexpensive, and generally well-tolerated medications, many clinicians and patients express uncertainty regarding the necessity of statin treatment in older adults. Citing concerns such as polypharmacy, muscle symptoms, and even potential cognitive changes with statins, many patients and health care providers elect to de-intensify or discontinue statin therapy during the process of aging. A lack of clear representation of older individuals in many clinical trials and practice guidelines may contribute to the ambiguity. However, the recently prevailing data and practice patterns supporting the benefits, safety, and tolerability of a variety of lipid-lowering therapeutics in older adults are discussed here, with particular mention of a potential protective effect from incident dementia among a statin-treated geriatric population and an admonishment of the historical concept of “too-low” low-density lipoprotein cholesterol (LDL-C) levels.

show abstract

Do Statins Affect Cognitive Health? A Narrative Review and Critical Analysis of the Evidence

Kazibwe,

Rikhi,

Mirzai

et al. 2024

Curr Atheroscler Rep

View full text Add to dashboard Cite

Purpose of Review Statins are the first-line treatment for hypercholesterolemia and play a key role in the prevention of cardiovascular disease (CVD). Current studies report mixed effects of statins on cognitive health, including harmful, neutral, and protective outcomes. However, these ongoing controversies about the potential cognitive adverse effects of statins may compromise their use in CVD prevention. Several factors may influence how statins affect cognition, including the unique cholesterol homeostasis in the brain, the limited permeability of the blood-brain barrier to lipoproteins, and the varying lipophilicity of different statins. This review examines the evidence linking statins to cognitive function and considers the effect of different dosages and treatment durations. Recent Findings Earlier studies suggested cognitive disturbances with statins, but recent evidence does not strongly support a link between statins and cognitive impairment. In fact, observational studies suggest potential neuroprotective benefits, though biases like selection bias, confounding and reverse causation limit definitive conclusions. Two large randomized controlled trials, STAREE and PREVENTABLE, are underway, and their results are expected to address some of these gaps in the literature. Summary Due to insufficient evidence in the current literature, well-designed randomized controlled trials are needed for a better understanding of statins’ effects on cognition. More data is needed regarding statin type, dose intensity, and treatment duration, which may affect cognitive outcomes. Future studies are also needed to examine how statins may affect cognition in specific high-risk groups, such as individuals with mild cognitive impairment, diabetes, cardiovascular disease, or chronic kidney disease.

show abstract

Statin use in dementia—Review and comparison of guideline recommendations

Cited by 3 publications

References 8 publications

Investigation into the vascular contributors to dementia and the associated treatments

Investigation into the vascular contributors to dementia and the associated treatments

Lipid-Targeted Atherosclerotic Risk Reduction in Older Adults: A Review

Do Statins Affect Cognitive Health? A Narrative Review and Critical Analysis of the Evidence

Contact Info

Product

Resources

About