Statin use not linked to cognitive decline, reassures JACC study

Australia: There has been an increasing consumer concern that statin use may lead to impaired memory and cognitive decline. Putting to rest all such concerns, a recent study has found no link between statin medication and cognitive decline, such as memory loss. The study, published in the Journal of the American College of Cardiology, involved more than 1,000 elderly individuals assessed over six years.

Researchers instead showed statin use to be protective against memory decline in some individuals at risk of dementia.

Statins, also known as HMG-CoA reductase inhibitors, are one of the most prescribed medications in the world. They are a class of lipid-lowering medications that reduce mortality in patients with heart disease, renal disease, diabetes, stroke, and other lipid disorders. Statins are not known to be associated with a risk for major adverse health advents. However, recent consumer concerns regarding its impact on cognition have been disturbing. The data from this new study are reassuring for consumers concerned about statin use and risk of memory decline.

Katherine Samaras, St. Vincent’s Hospital, Sydney, New South Wales, Australia, and colleagues sought to examine the association between statin use and changes in memory and global cognition in the elderly population over 6 years and brain volumes over 2 years. Interactions between statin use and known dementia risk factors were examined.

The study was led by researchers at the Garvan Institute of Medical Research and the Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney. It assessed changes to the brain in 1,037 elderly individuals (aged 70 to 90 years), measuring five areas of cognition using 13 different tests and MRI scans of the brain, over six years.

Outcome measures were memory and global cognition (by neuropsychological testing every 2 years) and total brain, hippocampal and parahippocampal volumes (by magnetic resonance) in a subgroup (n = 526).

Participants' medications and duration of use were categorized as statin ever-use versus never-use; continuous statin-use during observation versus never-use; specific statins (simvastatin, pravastatin, and atorvastatin) versus never-use; and statin initiation during observation period versus never-use.

Read Also: Bempedoic acid enhances LDL-C lowering effect of statins in high risk patients: JAMA

Key findings of the study include:

• Over 6 years there was no difference in the rate of decline in memory or global cognition between statin users and never users.


• Statin initiation during the observation period was associated with blunting the rate of memory decline.


• Exploratory analyses found statin use was associated with an attenuated decline in specific memory test performance in participants with heart disease and apolipoprotein Eε4 carriage.


• There was no difference in brain volume changes between statin users and never users.

In an accompanying editorial, Costantino Iadecola, MD, and Neal S. Parikh, MD, MS, from Weill Cornell Medicine in New York City said, "These data support the view that worries about cognitive impairment should not limit statin use and raise the possibility that statins may favorably alter cognitive trajectories in a group of elders at high risk of Alzheimer's disease."

The study, "Effects of Statins on Memory, Cognition, and Brain Volume in the Elderly," is published in the Journal of the American College of Cardiology.

DOI: https://doi.org/10.1016/j.jacc.2019.09.041

Journal Information: Journal of the American College of Cardiology