Statins Preventing Dementia

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Recommended: Pharmacology of statins- pharmacology research

QUESTION: What is the current data on statins causing or preventing dementia?
OBJECTIVE: To determine if dementia can be caused or prevented by the use of HMG-CoA reductase inhibitors: Pravastatin, Lovastatin, Simvastatin, Rosuvastatin, and Atorvastatin.
RETRIEVAL OF SOURCES: The journal articles and publications used in this review were searched using PubMed and Google scholar as well as the FDA references cited in the warning regarding cognitive impairment on the FDA website. Key search words used include: statins, dementia, cognitive function, HMG-coA reductase inhibitors, impaired memory.
STUDY SELECTION:
• Statins Prevent Dementia4-11 o 8 prospective cohort studies- Meta Analysis o 2003-2009 o All 8 studies with RR 95% CI for statins and dementia
• Statins Cause Dementia13,14 o 60 case reports o 1 case report o 1997-2002
DATA CONCLUSION:
• Cause Dementia: A look at the FDA references cited in the warning that statins could cause cognitive impairment showed: o The rate for cognitive adverse events with statins was low and this low rate was similar to the rates with other similarly therapeutic class medications.
• Prevent Dementia: Other journal articles and publications that showed a link between statin users and cognitive impairment suggested: o No increased evidence of Alzheimer disease as well as no difference in cognitive performance, processing speed, or memory.
CONCLUSION/RECOMMENDATION: Since the Food and Drug Administration based their warning on a few reports for “cognitive-related” adverse events with statins, as well as rare post-marketing reports of cognitive impairment, it is reasonable to recommend that statins still be used the same therapeutically as they always have. This recommendation is also based on the...

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...nal of Human Pharmacology and Drug Therapy. 2003; 23(7):871-880. doi: 10.1592/phco.23.7.871.32720.
14. Orsi A, Sherman O, Woldeselassie Z. Simvastatin-associated memory loss. Pharmacotherapy. 2001;21:767-9.
15. Haag MD, Hofman A, Koudstaal PJ, et al. Statins are associated with a reduced risk of Alzheimer disease re-gardless of lipophilicity. The Rotterdam Study. J Neurol Neurosurg Psychiatry. 2009; 80:13-17.
16. Soloman et al. Statins and dementia prevention: A population-based study (FINRISK). Alzheimer’s & Dementia. 2009; 5(4):2-104.
17. Steenland et al. Statins and Cognitive Decline in Older Adults with Normal Cognition or Mild Cognitive Impairment. J Am Geriatr Soc. 2013;61:1449–1455.
18. Hajjar et al. The Impact of the Use of Statins on the Prevalence of Dementia and the Progression of Cognitive Impairment. J Gerontol A Biol Sci Med Sci. 2002 Jul;57(7):M414-8.

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