Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment

Bibliographic Data

ID11173161
AuthorsMay A Beydoun (0000-0002-1050-4523, National Institute on Aging, corresponding author), Lori L Beason-Held, Lori L Beason‐Held (0000-0001-9057-6270, National Institute on Aging), Melissa H Kitner-Triolo, Melissa Kitner‐Triolo (National Institute on Aging), Hind A Beydoun (0000-0002-9704-328X, Eastern Virginia Medical School), Luigi Ferrucci (0000-0002-6273-1613, National Institute on Aging), Susan M Resnick (0000-0003-1115-7145, National Institute on Aging), Alan B Zonderman (0000-0002-6523-4778, National Institute on Aging)
Year2011
Volume65
Issue11
Pages949-957
Publication date2011-11-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJournal of Epidemiology and Community Health (JOURNAL)
Journal identifiersISSN: 0143-005X • E-ISSN: 1470-2738
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jech.2009.100826
PMID20841372
PMCIDPMC3024452
OpenAlexW2161990655
LanguageEN
Citations received3
References cited42

BACKGROUND: Statin use and serum cholesterol reduction have been proposed as preventions for dementia and mild cognitive impairment (MCI). METHODS: 1604 and 1345 eligible participants from the Baltimore Longitudinal Study of Aging (BLSA) were followed after age 50 for a median time of around 25 years, to examine the incidence of dementia (n=259) and MCI (n=138), respectively. Statin use (ever-use and time-dependent use), total cholesterol levels (TC; first visit and time-dependent), TC change trajectory from first visit and high-density lipoprotein (HDL-C):TC ratio (first visit and time-dependent) were the main exposures of interest. Cox proportional hazards models were used. RESULTS: Participants with incident dementia had a higher first-visit TC compared with participants who remained free of dementia and MCI, while first-visit TC was higher among statin ever-users compared with never-users (age-unadjusted associations). Statin users had a two- to threefold lower risk of developing dementia (HR=0.41; 95% CI 0.18 to 0.92), but not MCI, when considering time-dependent 'statin use' with propensity score model adjustment. This association remained significant independently of serum cholesterol exposures. An elevated first-visit TC was associated with reduced MCI risk (upper quartile (Q(4)) vs Q(1): HR=0.51; 95% CI 0.29 to 0.90). Compared with the lowest quartile (Q(1): 0.00-0.19), HDL-C:TC (time-dependent) in (Q(2): 0.19-0.24) was associated with reduced MCI risk (HR=0.58; 95% CI 0.34 to 0.98). Among men only, TC decline from first visit was significantly associated with increased dementia risk (HR=4.21; 95% CI 1.28 to 13.85). CONCLUSIONS: Statins may have multifactorial effects on dementia but not MCI risk. Future interventions may be warranted, and research should focus on optimal serum TC, HDL-C:TC ratio and TC change trajectories

Cholesterol · Confidence interval · Dementia · Disease · Incidence (geometry) · Longitudinal study · Proportional hazards model · Quartile · Statin · Alzheimer's disease research and treatments · Dementia and Cognitive Impairment Research · Internal Medicine · Lipoproteins and Cardiovascular Health · Medicine · Gerontology

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