The association of statin use and statin type and cognitive performance: analysis of the reasons for geographic and racial differences in stroke (REGARDS) study.
BACKGROUND
Statin use and type have been variably associated with impaired or improved cognitive performance.


OBJECTIVE
To assess the association of statin use and type (lipophilic vs hydrophilic) and cognitive impairment.


METHODS
Cross-sectional analysis of 24 595 participants (7191 statin users and 17 404 nonusers) age > or = 45 years, from a population-based national cohort study (Reasons for Geographic And Racial Differences in Stroke) enrolled between January 2003 and October 2008, with oversampling from the southeastern Stroke Belt and African Americans. Statin use and type were documented in participants' homes by a trained health professional. Cognitive performance was assessed with a prior validated instrument of global cognitive status (Six-Item Screener). Cognitive impairment was defined as a score of < 4.


RESULTS
Overall, an association of cognitive impairment and statin use was observed (8.6% of users vs 7.7% of nonusers had cognitive impairment, P = 0.014); but, after adjusting for variables known to be associated with cognition (age, gender, race, income, education level, and cardiovascular disease), the association was attenuated (odds ratio [OR]: 0.98, confidence interval [CI]: 0.87-1.10). No association was observed between statin type (lipophilic vs hydrophilic) and cognition (OR: 1.03, CI: 0.86-1.24), and there were no regional differences in cognitive impairment in statin users (8% in the Stroke Belt and 7.9% in other regions, P = 0.63).


CONCLUSIONS
Statin use and type were marginally associated with cognitive impairment. After adjusting for known variables that affect cognition, no association was observed. No regional differences were observed. This large study found no evidence to support an association between statins and cognitive performance.
University of Alabama at Birmingham, Division of Preventive Medicine, Birmingham, Alabama 35205, USA. sglasser@uab.edu
Stephen P
SP
Glasser
Virginia
V
Wadley
Suzanne
S
Judd
Bhumika
B
Kana
Valerie
V
Prince
Nancy
N
Jenny
Brett
B
Kissela
Monika
M
Safford
Ronald
R
Prineas
George
G
Howard
D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D003430:Cross-Sectional Studies; D019992:Databases as Topic; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D014481:United States / Q000453:epidemiology; D044465:White People
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors