Abstract 9486: Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults

Abstract

Background: The neurocognitive effect of statins in older adults remains uncertain. Objectives: To investigate the associations of statin use with cognitive decline and incident dementia among older adults. Methods: This analysis included 18,846 participants (aged ≥65 years) from a randomized trial of aspirin (ASPirin in Reducing Events in the Elderly, ASPREE). At baseline, participants had no experience of a CVD event, major physical disability, or diagnosed dementia, and were followed for a median (IQR) of 4.7 (3.5-5.6) years. Outcome measures included incident dementia and its subclassifications (probable Alzheimer’s disease [AD]; mixed presentations), changes in domain-specific cognition (global cognition, memory, language and executive function, psychomotor speed) and the composite of these domains. We examined the associations of baseline statin use with dementia using Cox proportional-hazards models, and with cognitive change using linear mixed-effects models, adjusting for confounders. The role of statin lipophilicity was also examined. Results: Compared with no statin, baseline statin use was not associated with incident dementia (adjusted HR [95%CI]: 1.16 [0.97-1.40]), probable AD (1.33 [1.00-1.77]) or mixed presentations of dementia (1.06 [0.82-1.35]) ( Table 1 ). Nor was it associated with changes in composite or domain-specific cognitive function scores over time ( Table 2 ). No differences were found in any outcomes between hydrophilic and lipophilic statin users ( Tables 1 & 2 ). Conclusions: In healthy adults aged ≥65 years without diagnosed dementia, statin therapy over 4.7 years was not associated with incident dementia or cognitive decline.