title: Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study.
abstract: BACKGROUND
  Lipid-lowering medications (LLMs) and especially statin drugs can delay cognitive decline and dementia onset in individuals with and without mild cognitive impairment (MCI) at baseline.
  
  
  METHODS
  A longitudinal, observational study was conducted of 3069 cognitively healthy elderly patients (≥75 years of age) who were enrolled in the Ginkgo Evaluation of Memory Study. The primary outcome measure was the time to adjudicated all-cause dementia and Alzheimer dementia (AD). The secondary outcome measure was the change in global cognitive function over time measured by scores from the Modified Mini-Mental State Exam (3MSE) and the cognitive subscale of the AD Assessment Scale (ADAS-Cog).
  
  
  RESULTS
  Among participants without MCI at baseline, the current use of statins was consistently associated with a reduced risk of all-cause dementia (hazard ratio [HR], 0.79; 95% confidence interval [95% CI], 0.65-0.96; P = .021) and AD (HR, 0.57; 95% CI, 0.39-0.85; P = .005). In participants who initiated statin therapy, lipophilic statins tended to reduce dementia risk more than nonlipophilic agents. In contrast, there was no significant association between LLM use (including statins), dementia onset, or cognitive decline in individuals with baseline MCI. However, in individuals without MCI at baseline, there was a trend for a neuroprotective effect of statins on cognitive decline.
  
  
  CONCLUSIONS
  Statins may slow the rate of cognitive decline and delay the onset of AD and all-cause dementia in cognitively healthy elderly individuals, whereas individuals with MCI may not have comparable cognitive protection from these agents. However, the results from this observational study need to be interpreted with caution and will require confirmation by randomized clinical trials stratifying treatment groups based on MCI status at baseline.
authors.affiliation: Department of Neurology, Penn State College of Medicine, Hershey, Pennsylvania, USA. kbettermann@hmc.psu.edu
authors.forename: Kerstin
authors.initials: K
authors.lastname: Bettermann
authors.forename: Alice M
authors.initials: AM
authors.lastname: Arnold
authors.forename: Jeff
authors.initials: J
authors.lastname: Williamson
authors.forename: Stephen
authors.initials: S
authors.lastname: Rapp
authors.forename: Kaycee
authors.initials: K
authors.lastname: Sink
authors.forename: James F
authors.initials: JF
authors.lastname: Toole
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Carlson
authors.forename: Sevil
authors.initials: S
authors.lastname: Yasar
authors.forename: Steven
authors.initials: S
authors.lastname: Dekosky
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D000544:Alzheimer Disease / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000187:drug effects*; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000627:therapeutic use*; D010936:Plant Extracts / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018697:Nootropic Agents; D010936:Plant Extracts