Atorvastatin associated with Dementia in a dose-dependent manner

Lipophilic statins like atorvastatin may be associated with cognitive and memory deficits in a dose-dependent manner, according to findings presented at the 2018 Alzheimer's Association International Conference, July 22-26 in Chicago, Illinois. Popular brands of Atorvastatin available in India include Atocor (Dr.Reddy's Lab), Storvas (Sun Pharma) and Atorva(Zydus Cadila).

Alex Kai Chan, from the Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Ontario, Canada, and colleagues conducted the study to determine the effect of statins (HMG-CoA reductase inhibitors) on cognition and memory.

Some literature have shown acute cognitive deficits after starting treatment whereas some have shown preventative effects against dementia with long-term treatment. "These mixed results in the literature may be attributed to a lack of rigorous studies distinguishing between lipophilic, blood-barrier permeable statins from hydrophilic impermeable statins, as well as a lack of objective clinical data acquired using detailed, valid measures," explained Chan.

For the study, the researchers analyzed data from patients who were seen at the Memory Disorders Clinic at St. Michael's Hospital between 2012-2017. The experimental group included adults taking atorvastatin (lipophilic statin) or rosuvastatin (hydrophilic statin) at the time of admission and control group consisted of patients not taking cholesterol-lowering drugs at the time of admission.

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Key Findings:

• Data from T-tests showed significantly lower Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and total Behavioural Neurology Assessment (BNA-R) scores in the atorvastatin group vs controls.


• The mean assessment scores for atorvastatin were 25.17 for MMSE, 19.41 for MoCA, and .7339 for BNA-R compared with 26.64, 21.55, and .7856 for controls, respectively.


• The atorvastatin group showed significantly lower BNA-R subsection scores regarding memory immediate recall (.5113 vs .5926 [control]), delayed recall (.4114 vs .5136 [control]), and working memory/attention (.7122 vs .7718 [control]).


• There were no significant differences between the rosuvastatin group and controls in any of the evaluated tests.


• Additional analyses further showed negative correlations between atorvastatin use and cognitive scores for all sections with significant associations found for delayed recall and visuospatial subsection scores on BNA-R.


• In general, no differences in subjective complaints were seen with any of the group Neuropsychological Impairment Scale (NIS) scores.


• However, significant negative correlations were specifically observed between atorvastatin doses and Total Indices Circled (TIC), Verbal learning (LV), and Academic Skills (ACD).

"Findings from this investigation suggest that lipophilic, blood-brain barrier penetrable statins may be associated with deficits in cognition and memory, possibly in a dose-dependent relationship," concluded Chan.