BMJ  2005;331 (1 October), doi:10.1136/bmj.331.7519.0-f

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POEM^*

Statins are not associated with decreased risk of dementia

Question Are statins associated with a decreased risk of developing dementia?

Synopsis Several case-control studies have suggested that use of statins is associated with a lower risk of developing dementia. Since these kinds of studies have many limitations, they are among the weakest designs from which causal inferences can be drawn. These authors "kick it up a notch"—they annually evaluated almost 2800 patients over 65 who didn't have dementia. They don't tell us if the evaluators knew whether the patients used statins, and also don't tell us the number of patients who took statins. The researchers followed the patients for a median of five years, and they had more than 13 000 person years in the group of patients receiving no lipid lowering drugs, nearly 1300 person years in those taking statins, and about 500 person years in a group receiving non-statin lipid lowering drugs. Overall, about 30% of the patients developed dementia. After other factors associated with dementia were taken into account, the incidence of dementia among statin users was the same as for those not using statins.

Bottom line In this prospective study, patients over 65 who took statins developed dementia at the same rate as those not using statins.

Level of evidence 2b (see www.infopoems.com/levels.html). Individual cohort study or low quality randomised controlled trials (< 80% follow-up).

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Rea TD, Breitner JC, Psaty BM, et al. Statin use and the risk of incident dementia: the cardiovascular health study. Arch Neurol 2005;62: 1047-51[Abstract/Free Full Text].

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^* Patient-Oriented Evidence that Matters. See editorial ( BMJ 2002;325: 983[Free Full Text])

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