title: Statins Reduces the Risk of Dementia in Patients with Late-Onset Depression: A Retrospective Cohort Study.
abstract: OBJECTIVE
  Patients with late-onset depression (LOD) have been reported to run a higher risk of subsequent dementia. The present study was conducted to assess whether statins can reduce the risk of dementia in these patients.
  
  
  METHODS
  We used the data from National Health Insurance of Taiwan during 1996-2009. Standardized Incidence Ratios (SIRs) were calculated for LOD and subsequent dementia. The criteria for LOD diagnoses included age ≥65 years, diagnosis of depression after 65 years of age, at least three service claims, and treatment with antidepressants. The time-dependent Cox proportional hazards model was applied for multivariate analyses. Propensity scores with the one-to-one nearest-neighbor matching model were used to select matching patients for validation studies. Kaplan-Meier curve estimate was used to measure the group of patients with dementia living after diagnosis of LOD.
  
  
  RESULTS
  Totally 45,973 patients aged ≥65 years were enrolled. The prevalence of LOD was 12.9% (5,952/45,973). Patients with LOD showed to have a higher incidence of subsequent dementia compared with those without LOD (Odds Ratio: 2.785; 95% CI 2.619-2.958). Among patients with LOD, lipid lowering agent (LLA) users (for at least 3 months) had lower incidence of subsequent dementia than non-users (Hazard Ratio = 0.781, 95% CI 0.685-0.891). Nevertheless, only statins users showed to have reduced risk of dementia (Hazard Ratio = 0.674, 95% CI 0.547-0.832) while other LLAs did not, which was further validated by Kaplan-Meier estimates after we used the propensity scores with the one-to-one nearest-neighbor matching model to control the confounding factors.
  
  
  CONCLUSIONS
  Statins may reduce the risk of subsequent dementia in patients with LOD.
authors.affiliation: Department of Psychiatry, Taipei City Hospital, Renai Branch, Taipei, Taiwan; National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Ya-Hsu
authors.initials: YH
authors.lastname: Yang
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Teng
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Nursing, Yuanpei University, Hsinchu, Taiwan.
authors.forename: Yen-Ting
authors.initials: YT
authors.lastname: Lai
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Chih-Ching
authors.initials: CC
authors.lastname: Lin
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Yang
authors.affiliation: Department of Child Psychiatry, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan.
authors.forename: Hsiang-Lin
authors.initials: HL
authors.lastname: Chan
authors.affiliation: Department of Child Psychiatry, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan.
authors.forename: Yi-Hsuan
authors.initials: YH
authors.lastname: Hsieh
authors.affiliation: Department of Child Psychiatry, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan.
authors.forename: Chiao-Fan
authors.initials: CF
authors.lastname: Lin
authors.affiliation: Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhong-Xing Branch, Taipei, Taiwan.
authors.forename: Fu-Ying
authors.initials: FY
authors.lastname: Hsu
authors.affiliation: College of medicine & Graduate institute of Business Administration, Fu Jen Catholic University, New Taipei city, Taiwan.
authors.forename: Chih-Kuang
authors.initials: CK
authors.lastname: Liu
authors.affiliation: National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhong-Xing Branch, Taipei, Taiwan; College of medicine & Graduate institute of Business Administration, Fu Jen Catholic University, New Taipei city, Taiwan.
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology* / Q000517:prevention & control* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy; D015994:Incidence; D008297:Male; D015995:Prevalence; D065840:Protective Factors; D012189:Retrospective Studies; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors