Association of statin use with cognitive decline in elderly African Americans.
BACKGROUND
Previously reported associations between statin use and incident dementia or cognitive decline have been inconsistent. We report the results from a 3-year prospective study on the association of statin use on cognitive decline and incident dementia in elderly African Americans.


METHODS
A community-based cohort of 1,146 African Americans aged 70 and older living in Indianapolis, Indiana, was evaluated in 2001 and 2004. The instrument used for cognitive assessment was the Community Screening Interview for Dementia (CSI-D). Cognitive decline was defined as CSI-D scores measured at 2001 minus scores at 2004. Measurements of low-density lipoprotein cholesterol (LDL-C) and C-reactive protein (CRP) were obtained from baseline blood samples.


RESULTS
Adjusting for age at baseline, gender, education, and the possession of ApoE epsilon 4 allele, baseline statin use was associated with less cognitive decline (p = 0.0177). There were no significant interactions of statin use when LDL-C and CRP were included. Logistic regression with the four independent variables showed that statin use may be associated with a reduction in incident dementia (OR = 0.32; p = 0.0673). Association with cognitive decline was less clear when investigating statin use over time. Significance remained only for those who discontinued prior to follow-up compared to continuous users or users who started after baseline.


CONCLUSIONS
The relationship between statin use and cognitive decline is complex and subjected to unknown confounders. This effect may not be associated with the cholesterol lowering or anti-inflammatory action of statins.
Szwast
S J
SJ
Department of Psychiatry, Indiana University School of Medicine, 1111 West 10th Street, PB A319, Indianapolis, IN 46202, USA. sszwast@iupui.edu
Hendrie
H C
HC
Lane
K A
KA
Gao
S
S
Taylor
S E
SE
Unverzagt
F
F
Murrell
J
J
Deeg
M
M
Ogunniyi
A
A
Farlow
M R
MR
Hall
K S
KS
D001741:Black or African American / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data*; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D001057:Apolipoproteins E / Q000235:genetics; D002097:C-Reactive Protein / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D003072:Cognition Disorders / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D003704:Dementia / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D018450:Disease Progression; D004660:Encephalitis / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D005260:Female; D005838:Genotype; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D007196:Indiana / Q000453:epidemiology; D008297:Male; D015233:Models, Statistical; D009483:Neuropsychological Tests; D016896:Treatment Outcome
D001057:Apolipoproteins E; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein