title: Statin use and incident dementia: a nationwide cohort study of Taiwan.
abstract: BACKGROUND
  Statins are widely used in clinical treatment. However, an U.S. Food and Drug Administration issued health alert has raised concerns for the adverse effects of statin-associated confusion and memory loss in the elderly people. It is necessary to clarify the relationship between statin use and risk of incident dementia as well as whether class effects exist.
  
  
  METHODS
  In this population-based retrospective cohort study, total 33,398 patients aged ≥ 60 years were selected from a subset of the Taiwan National Health Insurance Research Databases and followed up for tracking the occurrence of any type of dementia from 2000 to 2010. The Cox proportional hazards models were used.
  
  
  RESULTS
  Compared to nonusers, statin users had a significantly lower risk of incident dementia (hazard ratio [HR], 0.78; 95% CI, 0.72-0.85, p<0.001). The potency and the cumulative duration of statin utilized were associated with the reducing risk of dementia. After stratifying by gender, the risk of incident dementia was lower in female statin users (HR, 0.76; 95% CI, 0.68-0.85, p<0.001) than in male statin users (HR, 0.86; 95% CI, 0.75-0.98, p=0.024). Higher potency and longer cumulative duration of statin use were required for reducing the risk of incident dementia in male patients than in female patients.
  
  
  CONCLUSIONS
  Statin use was associated with a significantly lower risk of dementia in the elderly patients in Taiwan. The potency and the cumulative duration of statin utilized played critical roles.
authors.affiliation: Institute of Public Health, National Yang Ming University, Taipei, Taiwan; Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Chian-Ying
authors.initials: CY
authors.lastname: Chou
authors.affiliation: Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan; Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan; College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yueh-Ching
authors.initials: YC
authors.lastname: Chou
authors.affiliation: Institute of Public Health, National Yang Ming University, Taipei, Taiwan.
authors.forename: Yiing-Jenq
authors.initials: YJ
authors.lastname: Chou
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Yang
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan. Electronic address: syhuang@ym.edu.tw.
authors.forename: Nicole
authors.initials: N
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology*; D015897:Comorbidity; D003221:Confusion / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology; D050171:Dyslipidemias / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Alzheimer disease; Dementia; Elderly; Gender; Retrospective cohort; Statin