Statins and cognitive decline in patients with Alzheimer's and mixed dementia: a longitudinal registry-based cohort study.
Alzheimers Res Ther
; 15(1): 220, 2023 12 20.
Article
en En
| MEDLINE
| ID: mdl-38115091
ABSTRACT
BACKGROUND:
Disturbances in brain cholesterol homeostasis may be involved in the pathogenesis of Alzheimer's disease (AD). Lipid-lowering medications could interfere with neurodegenerative processes in AD through cholesterol metabolism or other mechanisms.OBJECTIVE:
To explore the association between the use of lipid-lowering medications and cognitive decline over time in a cohort of patients with AD or mixed dementia with indication for lipid-lowering treatment.METHODS:
A longitudinal cohort study using the Swedish Registry for Cognitive/Dementia Disorders, linked with other Swedish national registries. Cognitive trajectories evaluated with mini-mental state examination (MMSE) were compared between statin users and non-users, individual statin users, groups of statins and non-statin lipid-lowering medications using mixed-effect regression models with inverse probability of drop out weighting. A dose-response analysis included statin users compared to non-users.RESULTS:
Our cohort consisted of 15,586 patients with mean age of 79.5 years at diagnosis and a majority of women (59.2 %). A dose-response effect was demonstrated taking one defined daily dose of statins on average was associated with 0.63 more MMSE points after 3 years compared to no use of statins (95% CI 0.33;0.94). Simvastatin users showed 1.01 more MMSE points (95% CI 0.06;1.97) after 3 years compared to atorvastatin users. Younger (< 79.5 years at index date) simvastatin users had 0.80 more MMSE points compared to younger atorvastatin users (95% CI 0.05;1.55) after 3 years. Simvastatin users had 1.03 more MMSE points (95% CI 0.26;1.80) compared to rosuvastatin users after 3 years. No differences regarding statin lipophilicity were observed. The results of sensitivity analysis restricted to incident users were not consistent.CONCLUSIONS:
Some patients with AD or mixed dementia with indication for lipid-lowering medication may benefit cognitively from statin treatment; however, further research is needed to clarify the findings of sensitivity analyses.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_doencas_nao_transmissiveis
Asunto principal:
Inhibidores de Hidroximetilglutaril-CoA Reductasas
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Enfermedad de Alzheimer
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Disfunción Cognitiva
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Demencias Mixtas
Límite:
Aged
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Female
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Humans
Idioma:
En
Revista:
Alzheimers Res Ther
Año:
2023
Tipo del documento:
Article
País de afiliación:
Suecia