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© 2008 American Academy of Neurology Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort studyFrom the Department of Epidemiology (C.C., M.N.H., S.G.), Division of General Internal Medicine (K.M.L.), and Department of Biostatistics (J.D.K.), University of Michigan, Ann Arbor. Address correspondence and reprint requests to Dr. Mary N. Haan, University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, MI 48104 mnhaan{at}umich.edu. Objective: Evidence of a relation between use of lipid lowering drugs and cognitive outcomes is mixed. This study aimed to test the association between use of statins and incidence of dementia and cognitive impairment without dementia (CIND) over 5 years of follow-up. Methods: Data were from a population-based cohort study comprising 1,789 older Mexican Americans. All participants had cognitive and clinical evaluations performed every 12 to 15 months. Participants who fell below specified cutpoints on cognitive tests were then evaluated clinically. Dementia diagnoses were finalized by an adjudication team. A total of 1,674 participants free of dementia/CIND at baseline were included in these analyses. Statin use was verified at each participant's home by medicine cabinet inspection. Cox proportional hazards models were used to evaluate the association between statin use and incidence of dementia/CIND.
Results: Overall, 452 of 1,674 participants (27%) took statins at any time during the study. Over the 5-year follow-up period, 130 participants developed dementia/CIND. In Cox proportional hazards models adjusted for education, smoking status, presence of at least one APOE Conclusion: Statin users were less likely to have incident dementia/cognitive impairment without dementia during a 5-year follow-up. These results add to the emerging evidence suggesting a protective effect of statin use on cognitive outcomes.
Abbreviations: 3MSE = Modified Mini-Mental State Examination; AD = Alzheimer disease; ATP = Adult Treatment Panel; CDC = Centers for Disease Control; CIND = cognitive impairment without dementia; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders–IV; FPG = fasting plasma glucose; IQCODE = Informant Questionnaire on Cognitive Decline in the Elderly; LDL-C = low density-lipoprotein cholesterol; LLT = lipid lowering therapy; MCI = mild cognitive impairment; NINCDS-ADRDA = National Institute of Neurologic and Communicative Disorders and Stroke–Alzheimer Disease and Related Disorders Association; PROSPER = Prospective Study of Pravastatin in the Elderly; SALSA = Sacramento Area Latino Study on Aging; SENAS = Spanish English Neuropsychological Assessment Scales; SEVLT = Spanish and English Verbal Learning Test.
Supported by NIA AG12975, DK 60753. Disclosure: Caryn Cramer was employed by Pfizer Corporation during completion of her doctoral degree during which time this study was conducted. Pfizer did not provide any material support for this study, and did not participate in the design, conduct, management, analysis, interpretation, review, or approval of the study or the manuscript. The other authors have reported no conflicts of interest. Received October 23, 2007. Accepted in final form April 22, 2008. This article has been cited by other articles:
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4 allele, and history of stroke or diabetes at baseline, persons who had used statins were about half as likely as those who did not use statins to develop dementia/CIND (HR = 0.52; 95% CI 0.34, 0.80). 
