title: Lipid lowering agents are associated with a slower cognitive decline in Alzheimer's disease.
abstract: BACKGROUND
  Data from epidemiological studies and animal models imply that disturbances in cholesterol metabolism are linked to Alzheimer's disease susceptibility. Lipid lowering agents (LLAs) may have implications for the prevention of Alzheimer's disease.
  
  
  OBJECTIVE
  To investigate whether LLAs are associated with a slower cognitive decline in Alzheimer's disease.
  
  
  METHODS
  An observational study in 342 Alzheimer patients followed in a memory clinic for 34.8 months (mean age 73.5 years, mini-mental state examination score (MMSE) 21.3 at entry); 129 were dyslipaemic treated with LLAs (47% with statins), 105 were untreated dyslipaemic, and 108 were normolipaemic. The rate of cognitive decline was calculated as the difference between the first and last MMSE score, divided by the time between the measurements, expressed by year. Patients were divided into slow and fast decliners according to their annual rate of decline (lower or higher than the median annual rate of decline in the total population).
  
  
  RESULTS
  Patients treated with LLAs had a slower decline on the MMSE (1.5 point/year, p = 0.0102) than patients with untreated dyslipaemia (2.4 points/year), or normolipaemic patients (2.6 points/year). Patients with a slower decline were more likely to be treated with LLAs. Logistic regression analysis, with low annual cognitive decline as the dependent variable, showed that the independent variable LLA (treated with or not) was positively associated with the probability of lower cognitive decline (odds ratio = 0.45, p = 0.002).
  
  
  CONCLUSIONS
  LLAs may slow cognitive decline in Alzheimer's disease and have a neuroprotective effect. This should be confirmed by placebo controlled randomised trials in patients with Alzheimer's disease and no dyslipaemia.
authors.affiliation: Department of Neurology, University Hospital, 59037 Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Masse
authors.forename: R
authors.initials: R
authors.lastname: Bordet
authors.forename: D
authors.initials: D
authors.lastname: Deplanque
authors.forename: A
authors.initials: A
authors.lastname: Al Khedr
authors.forename: F
authors.initials: F
authors.lastname: Richard
authors.forename: C
authors.initials: C
authors.lastname: Libersa
authors.forename: F
authors.initials: F
authors.lastname: Pasquier
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000503:physiopathology; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008569:Memory Disorders / Q000188:drug therapy / Q000209:etiology; D008609:Mental Status Schedule; D016896:Treatment Outcome
chemical_list: D000960:Hypolipidemic Agents