title: Statin use and the risk of incident dementia: the Cardiovascular Health Study.
abstract: BACKGROUND
  Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular risk through mechanisms that might affect the development of dementia.
  
  
  OBJECTIVE
  To evaluate whether statin use is associated with a lower risk of dementia compared with never use of lipid-lowering agents (LLAs).
  
  
  METHODS
  Cohort study of community-dwelling adults 65 years and older. The analysis included 2798 participants free of dementia at baseline.
  
  
  METHODS
  Using Cox proportional hazards regression analysis, we estimated the risk of incident all-cause and type-specific dementia associated with time-dependent statin therapy compared with never use of LLAs. The primary analyses incorporated a 1-year lag between exposure and outcome. Secondary analyses included the final year of exposure and modeled statin use as current use vs nonuse to simulate a case-control approach.
  
  
  RESULTS
  Compared with never use of LLAs, ever use of statins was not associated with the risk of all-cause dementia (multivariable-adjusted hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.77-1.52), Alzheimer disease alone (HR, 1.21; 95% CI, 0.76-1.91), mixed Alzheimer disease and vascular dementia (HR, 0.87; 95% CI, 0.44-1.72), or vascular dementia alone (HR, 1.36; 95% CI, 0.61-3.06). In contrast, in secondary analyses, current use of statins compared with nonuse of LLAs was associated with HRs of 0.69 (95% CI, 0.46-1.02) for all-cause dementia and 0.56 (95% CI, 0.35-0.92) for any Alzheimer disease.
  
  
  CONCLUSIONS
  In this cohort study, statin therapy was not associated with a decreased risk of dementia. Methodological differences may explain why results of this cohort investigation differ from those of prior case-control studies. Additional investigation is needed to determine whether and for whom statin use may affect dementia risk.
authors: Department of Medicine, University of Washington, Seattle 98101, USA. rea123@u.washington.edu
authors: Thomas D
authors: TD
authors: Rea
authors: John C
authors: JC
authors: Breitner
authors: Bruce M
authors: BM
authors: Psaty
authors: Annette L
authors: AL
authors: Fitzpatrick
authors: Oscar L
authors: OL
authors: Lopez
authors: Anne B
authors: AB
authors: Newman
authors: William R
authors: WR
authors: Hazzard
authors: Peter P
authors: PP
authors: Zandi
authors: Gregory L
authors: GL
authors: Burke
authors: Constantine G
authors: CG
authors: Lyketsos
authors: Charles
authors: C
authors: Bernick
authors: Lewis H
authors: LH
authors: Kuller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D015331:Cohort Studies; D003704:Dementia / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D008297:Male
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors