Can statin therapy really reduce the risk of Alzheimer's disease and slow its progression?
OBJECTIVE
Statins are the most used cholesterol-lowering agents worldwide. Earlier studies suggested that they may have preventive effects in Alzheimer's disease. However, prospective studies have questioned this hypothesis.


RESULTS
Statins regulate beta-amyloid metabolism and microglial activation. Pathologically, patients with Alzheimer's disease have more severe atherosclerosis in cerebral arteries than do controls. Such lesions may cause cerebral hypoperfusion, a risk factor for dementia and cognitive decline. Although most population-based studies have failed to show a beneficial effect of statins in Alzheimer's disease, two randomized controlled trials suggested that statins slow cognitive decline in mild to moderate Alzheimer's disease.


CONCLUSIONS
There is still some hope that statins reduce the incidence of Alzheimer's disease and slow its progression. Large-scale randomized controlled trials of simvastatin and atorvastatin for mild to moderate Alzheimer's disease are underway, which might provide more conclusive results than earlier studies.
Miida
Takashi
T
Division of Clinical Preventive Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. miida@med.niigata-u.ac.jp
Takahashi
Akihiro
A
Tanabe
Naohito
N
Ikeuchi
Takeshi
T
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000517:prevention & control*; D018450:Disease Progression; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D011446:Prospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors