title: Effects of statin use on muscle strength, cognition, and depressive symptoms in older adults.
abstract: OBJECTIVE
  To determine the relationship between hydroxymethyl glutaryl coenzyme A reductase inhibitor (statin) use and proximal muscle strength, cognition, and depression in older adults.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Outpatient primary care clinics.
  
  
  METHODS
  Seven hundred fifty-six community-dwelling veterans aged 65 and older.
  
  
  METHODS
  Timed chair stands (a measure of proximal muscle strength), Trail Making Test Part B (a measure of cognition), and the Center for Epidemiologic Studies Depression Scale score were measured at baseline and 1-year follow-up. Participants were assessed for statin prescriptions (and indications for or contraindications to their use), concomitant medication use, comorbidities, and other potential confounders.
  
  
  RESULTS
  Statin users (n=315) took a mean 6.6 medications, versus 4.6 for nonusers (n=441), and had a median duration of statin use of 727 days. Statin users were more likely to be white and had (as expected) more cardiac, cerebrovascular, and peripheral vascular disease. Based on multivariable models adjusting for pertinent covariates, statin users performed modestly better than nonusers for timed chair stands (-0.5 seconds; P=.04), Trail Making Test Part B (-7.7 seconds; P=.08), and depression scores (-0.2 points; P=.49) at follow-up. Of potentially high-risk participants (based on age, comorbidity, and number of medications), statin users also showed similar 1-year changes as nonusers, although worsened depression scores were found in those with greater comorbidity (+0.88 points; P=.10).
  
  
  CONCLUSIONS
  Older, community-dwelling male participants taking maintenance statin therapy had similar outcomes to those of nonusers in tests of muscle strength, cognition, and depression, but further examination of benefits and harms in different subgroups is warranted.
authors.affiliation: Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA. joseph.agostini@yale.edu
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Agostini
authors.forename: Mary E
authors.initials: ME
authors.lastname: Tinetti
authors.forename: Ling
authors.initials: L
authors.lastname: Han
authors.forename: Gail
authors.initials: G
authors.lastname: McAvay
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Foody
authors.forename: John
authors.initials: J
authors.lastname: Concato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000187:drug effects*; D015331:Cohort Studies; D015897:Comorbidity; D003237:Connecticut; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D053580:Muscle Strength / Q000187:drug effects*; D009483:Neuropsychological Tests; D011320:Primary Health Care; D011446:Prospective Studies; D018570:Risk Assessment; D014728:Veterans / Q000706:statistics & numerical data
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors