Abstract
BackgroundSome observational studies have found a significant association between the use of statin and a reduced risk of dementia. However, the results of these studies are unclear in patients with rheumatoid arthritis (RA). This study is to determine the association between the use of statins and the incidence of dementia according to sex and age-related differences in patients with RA.MethodsWe conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2003–2016). The primary outcome assessed was the risk of dementia by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was used to estimate the adjusted hazard ratio of new-onset dementia. Subgroup analysis was also conducted.ResultsAmong the 264,036 eligible patients with RA aged > 40 years, statin users were compared with non-statin users by propensity score matching at a ratio of 1:1 (25,764 in each group). However, no association was found between the use of statins and the risk of new-onset dementia (NOD) in patients with RA (HR: 1.01; 95% CI: 0.97–1.06). The subgroup analysis identified the use of statin as having a protective effect against developing NOD in male and older patients.ConclusionNo association was observed between the use of a statin and the risk of NOD in patients with RA, including patients of both genders and aged 40–60 years, but these parameters were affected by gender and age. The decreased risk of NOD in patients with RA was greater among older male patients. Use of a statin in older male (> 60 years) patients with RA may be needed in clinical practice to prevent dementia.
Highlights
Some observational studies have found a significant association between the use of statin and a reduced risk of dementia
Study population The study population comprised patients with rheumatoid arthritis (RA) (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code: 714.0) who were admitted to the hospital or outpatients who were newly diagnosed with hyperlipidemia (ICD-9-CM code272.X) and were statin users between 2003 and 2016
Given the differences in baseline characteristics and dementia risk between the statin users and non-statin users, we applied age, sex, RA duration, and propensity score matching at a ratio of 1:1 for patients with RA with and without statin use
Summary
Some observational studies have found a significant association between the use of statin and a reduced risk of dementia. Rheumatoid arthritis (RA) is a common autoimmune disorder that is characterized by systemic inflammatory polyarthritis. It affects approximately 1% of the global population [1, 2]. There were more than 50 million people living with dementia in 2016 worldwide, and this number is expected to increase with an increase in life expectancy [7]. It is one of the most common causes of disability among this group [8]. Minimizing the impact of incident dementia on patients with RA and their families is a crucial health-related challenge for health care personnel
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