Statins and Cognition: A Systematic Review and Meta-analysis of Short- and Long-term Cognitive Effects

FDA Drug Safety Communication: important safety label changes to cholesterol-lowering statin drugs. US FDA website. http://www.fda.gov/Drugs/DrugSafety/ucm293101.htm. Accessed August 15, 2013. Zamrini, 2004, Association between statin use and Alzheimer’s disease, Neuroepidemiology, 23, 94, 10.1159/000073981 Zandi, 2005, Do statins reduce risk of incident dementia and Alzheimer disease?, Arch Gen Psychiatry, 62, 217, 10.1001/archpsyc.62.2.217 Bettermann, 2012, Statins, risk of dementia, and cognitive function: secondary analysis of the Ginkgo Evaluation of Memory study, J Stroke Cerebrovasc Dis, 21, 436, 10.1016/j.jstrokecerebrovasdis.2010.11.002 Beydoun, 2011, Statins and serum cholesterol’s associations with incident dementia and mild cognitive impairment, J Epidemiol Community Health, 65, 949, 10.1136/jech.2009.100826 Evans, 2009, Statin-associated adverse cognitive effects: survey results from 171 patients, Pharmacotherapy, 29, 800, 10.1592/phco.29.7.800 Orsi, 2001, Simvastatin-associated memory loss, Pharmacotherapy, 21, 767, 10.1592/phco.21.7.767.34577 Wagstaff, 2003, Statin-associated memory loss: analysis of 60 case reports and review of the literature, Pharmacotherapy, 23, 871, 10.1592/phco.23.7.871.32720 Parker, 2010, Changes in memory function and neuronal activation associated with atorvastatin therapy, Pharmacotherapy, 30, 236e, 10.1592/phco.30.6.625 Benito-León, 2010, Statins and cognitive functioning in the elderly: a population-based study, J Alzheimers Dis, 21, 95, 10.3233/JAD-2010-100180 Muldoon, 2000, Effects of lovastatin on cognitive function and psychological well-being, Am J Med, 108, 538, 10.1016/S0002-9343(00)00353-3 Muldoon, 2004, Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults, Am J Med, 117, 823, 10.1016/j.amjmed.2004.07.041 Trompet, 2010, Pravastatin and cognitive function in the elderly: results of the PROSPER study, J Neurol, 257, 85 Jukema, 2012, The controversies of statin therapy: weighing the evidence, J Am Coll Cardiol, 60, 875, 10.1016/j.jacc.2012.07.007 Taylor, 2013, Statins for the primary prevention of cardiovascular disease, Cochrane Database Syst Rev, 1, CD004816 Redberg, 2012, Healthy men should not take statins, JAMA, 307, 1491, 10.1001/jama.2012.423 Rosenberg M. Do you really need that statin? this expert says no. Huffpost Healthy Living: The Blog. The Huffington Post. http://www.huffingtonpost.com/martha-rosenberg/statins_b_1818370.html. Accessed August 15, 2013. Parker-Pope T. A heart helper may come at a price for the brain. The Well Column. The New York Times. http://well.blogs.nytimes.com/2012/03/05/help-for-the-heart-comes-with-a-price-for-the-brain/?_r=0. Accessed August 15, 2013. Jick, 2000, Statins and the risk of dementia, Lancet, 356, 1627, 10.1016/S0140-6736(00)03155-X Wolozin, 2000, Decreased prevalence of Alzheimer disease associated with 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors, Arch Neurol, 57, 1439, 10.1001/archneur.57.10.1439 Rea, 2005, Statin use and the risk of incident dementia: the Cardiovascular Health Study, Arch Neurol, 62, 1047, 10.1001/archneur.62.7.1047 2002, MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial, Lancet, 360, 7, 10.1016/S0140-6736(02)09327-3 Shepherd, 2002, Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial, Lancet, 360, 1623, 10.1016/S0140-6736(02)11600-X Rodriguez, 2002, Use of lipid-lowering drugs in older adults with and without dementia: a community-based epidemiological study, J Am Geriatr Soc, 50, 1852, 10.1046/j.1532-5415.2002.50515.x Zhou, 2007, Prevention and treatment of dementia or Alzheimer’s disease by statins: a meta-analysis, Dement Geriatr Cogn Disord, 23, 194, 10.1159/000099037 Wong, 2013, Statins in the prevention of dementia and Alzheimer’s disease: a meta-analysis of observational studies and an assessment of confounding, Pharmacoepidemiol Drug Saf, 22, 345, 10.1002/pds.3381 Song Y, Nie H, Xu Y, Zhang L, Wu Y. Association of statin use with risk of dementia: a meta-analysis of prospective cohort studies [published online ahead of print March 6, 2013]. Geriatr Gerontol Int. doi:10.1111/ggi.12044. Haynes, 2005, Optimal search strategies for retrieving scientifically strong studies of treatment from Medline: analytical survey, BMJ, 330, 1179, 10.1136/bmj.38446.498542.8F Wechsler, 1997 Higgins J. Chapter 8: assessing risk of bias in included studies: Table 8.5 a. In: Cochrane Handbook for Systematic Reviews of Interventions. http://handbook.cochrane.org/. Accessed August 6, 2012. Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed August 15, 2013. Harrison, 1994, Do cholesterol-lowering agents affect brain activity? a comparison of simvastatin, pravastatin, and placebo in healthy volunteers, Br J Clin Pharmacol, 37, 231, 10.1111/j.1365-2125.1994.tb04268.x Kostis, 1994, Central nervous system effects of HMG CoA reductase inhibitors: lovastatin and pravastatin on sleep and cognitive performance in patients with hypercholesterolemia, J Clini Pharmacol, 34, 989, 10.1002/j.1552-4604.1994.tb01971.x Cutler, 1995, Effects of treatment with simvastatin and pravastatin on cognitive function in patients with hypercholesterolaemia, Br J Clin Pharmacol, 39, 333, 10.1111/j.1365-2125.1995.tb04458.x Gengo, 1995, Effects of treatment with lovastatin and pravastatin on daytime cognitive performance, Clin Cardiol, 18, 209, 10.1002/clc.4960180406 Parale, 2006, Effects of atorvastatin on higher functions, Eur J Clin Pharmacol, 62, 259, 10.1007/s00228-005-0073-z Summers, 2007, Effect of atorvastatin on cognitive function in patients from the Lipid Lowering and Onset of Renal Disease (LORD) trial, Pharmacotherapy, 27, 183, 10.1592/phco.27.2.183 Berk-Planken, 2002, Atovastatin, diabetic dyslipidemia, and cognitive functioning, Diabetes Care, 25, 1250, 10.2337/diacare.25.7.1250 Gibellato, 2001, Effects of lovastatin and pravastatin on cognitive function in military aircrew, Aviat Space Environ Med, 72, 805 Santanello, 1997, Effect of pharmacologic lipid lowering on health-related quality of life in older persons: results from the Cholesterol Reduction in Seniors Program (CRISP) Pilot Study, J Am Geriatr Soc, 45, 8, 10.1111/j.1532-5415.1997.tb00971.x Glasser, 2010, The association of statin use and statin type and cognitive performance: analysis of the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study, Clin Cardiol, 33, 280, 10.1002/clc.20758 Smeeth, 2009, Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials, Br J Clin Pharmacol, 67, 99, 10.1111/j.1365-2125.2008.03308.x Hajjar, 2002, 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, 57, 414, 10.1093/gerona/57.7.M414 Yaffe, 2002, Serum lipoprotein levels, statin use, and cognitive function in older women, Arch Neurol, 59, 378, 10.1001/archneur.59.3.378 Rockwood, 2002, Use of lipid-lowering agents, indication bias, and the risk of dementia in community-dwelling elderly people, Arch Neurol, 59, 223, 10.1001/archneur.59.2.223 Dufouil, 2005, APOE genotype, cholesterol level, lipid-lowering treatment, and dementia: the Three-City Study, Neurology, 64, 1531, 10.1212/01.WNL.0000160114.42643.31 Solomon, 2009, Serum total cholesterol, statins and cognition in non-demented elderly, Neurobiol Aging, 30, 1006, 10.1016/j.neurobiolaging.2007.09.012 Bernick, 2005, Statins and cognitive function in the elderly: the Cardiovascular Health Study, Neurology, 65, 1388, 10.1212/01.wnl.0000182897.18229.ec Sparks, 2010, Cholesterol and cognitive performance in normal controls and the influence of elective statin use after conversion to mild cognitive impairment: results in a clinical trial cohort, Neurodegener Dis, 7, 183, 10.1159/000295660 Li, 2004, Statin therapy and risk of dementia in the elderly: a community-based prospective cohort study, Neurology, 63, 1624, 10.1212/01.WNL.0000142963.90204.58 Wolozin, 2007, Simvastatin is associated with a reduced incidence of dementia and Parkinson’s disease, BMC Med, 5, 20, 10.1186/1741-7015-5-20 Li, 2010, Age-varying association between statin use and incident Alzheimer’s disease, J Am Geriatr Soc, 58, 1311, 10.1111/j.1532-5415.2010.02906.x Arvanitakis, 2008, Statins, incident Alzheimer disease, change in cognitive function, and neuropathology, Neurology, 70, 1795, 10.1212/01.wnl.0000288181.00826.63 Cramer, 2008, Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort study, Neurology, 71, 344, 10.1212/01.wnl.0000319647.15752.7b Haag, 2009, Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity: the Rotterdam Study, J Neurol Neurosurg Psychiatry, 80, 13, 10.1136/jnnp.2008.150433 Szwast, 2007, Association of statin use with cognitive decline in elderly African Americans, Neurology, 69, 1873, 10.1212/01.wnl.0000279333.77404.d7 Sparks, 2008, Reduced risk of incident AD with elective statin use in a clinical trial cohort, Curr Alzheimer Res, 5, 416, 10.2174/156720508785132316 Ancelin, 2012, Lipid lowering agents, cognitive decline, and dementia: the Three-City Study, J Alzheimers Dis, 30, 629, 10.3233/JAD-2012-120064 Hsia, 2011, J Am Coll Cardiol, 57, 1666, 10.1016/j.jacc.2010.09.082