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From the Department of Medicine (Dr. Bernick), University of Nevada School of Medicine, Las Vegas, Collaborative Health Studies Coordinating Center (Dr. Katz) and Department of Epidemiology (Dr. Smith), University of Washington, Seattle, Department of Public Health (Dr. Rapp), Wake Forest University, Winston–Salem, NC, Department of Radiology (Dr. Bhadelia), Tufts New England Medical Center, Boston, MA, School of Public Health (Dr. Carlson), Johns Hopkins University, Baltimore, MD, and Department of Epidemiology (Dr. Kuller), University of Pittsburgh, PA.
Address correspondence and reprint requests to Dr. C. Bernick, Division of Neurology, University of Nevada School of Medicine, 1707 W. Charleston Blvd., 220, Las Vegas, NV 89102; e-mail: cbernick{at}med.unr.edu
Objective: To examine the association of statin drug use on cognitive and MRI change in older adults.
Methods: Participants in the Cardiovascular Health Study, a longitudinal study of people age 65 or older, were classified into three groups determined by whether they were taking statin drugs on a continuous basis, intermittently, or not at all. The untreated group was further divided into categories based on National Cholesterol Education Program recommendations for lipid-lowering treatment. Participants with prevalent or incident clinical TIA or stroke or with baseline Modified Mini-Mental State Examination (3MS) scores at or below 80 were excluded. Outcomes examined included rate of change on the 3MS over an average observational period of 7 years, along with changes in MRI white matter grade and measures of atrophy.
Results: Three thousand three hundred thirty-four participants had adequate data for analysis. At baseline, the untreated group in which lipid-lowering drug treatment was recommended were slightly older, less likely to be on estrogen replacement, and had higher serum cholesterol and lower 3MS scores than the statin-treated group. The rate of decline on the 3MS was 0.48 point/year less in those taking statins compared with the untreated group for which treatment was recommended (p = 0.069) and 0.49 point/year less in statin users compared with the group in which lipid-lowering treatment was not recommended (p = 0.009). This effect remained after controlling for serum cholesterol levels. One thousand seven hundred thirty participants with baseline 3MS scores of >80 underwent cranial MRI scans on two occasions separated by 5 years. There was no significant difference in white matter grade change or atrophy measures between groups.
Conclusion: Statin drug use was associated with a slight reduction in cognitive decline in an elderly population. This relationship could not be completely explained by the effect of statins on lowering of serum cholesterol.
*For a full list of participating Cardiovascular Health Study investigators and institutions, see "About CHS: Principal Investigators and Study Sites" at http://www.chs-nhlbi.org
Supported by contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, and N01 HC-15103 from the National Heart, Lung, and Blood Institute.
Disclosure: The authors report no conflicts of interest.
Received September 3, 2004. Accepted in final form July 27, 2005.
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Neurology 2005 65: 1344-1345.
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