Abstract
We conducted a systematic review and meta-analysis to investigate whether the use of statins could be associated with the risk of all-caused dementia, Alzheimer’s disease (AD), vascular dementia (VaD), and mild cognitive impairment (MCI). Major electronic databases were searched until December 27th, 2017 for studies investigating use of statins and incident cognitive decline in adults. Random-effects meta-analyses calculating relative risks (RRs) were conducted to synthesize effect sizes of individual studies. Twenty-five studies met eligibility criteria. Use of statins was significantly associated with a reduced risk of all-caused dementia (k = 16 studies, adjusted RR (aRR) = 0.849, 95% CI = 0.787–0.916, p = 0.000), AD (k = 14, aRR = 0.719, 95% CI = 0.576–0.899, p = 0.004), and MCI (k = 6, aRR = 0.737, 95% CI = 0.556–0.976, p = 0.033), but no meaningful effects on incident VaD (k = 3, aRR = 1.012, 95% CI = 0.620–1.652, p = 0.961). Subgroup analysis suggested that hydrophilic statins were associated with reduced risk of all-caused dementia (aRR = 0.877; CI = 0.818–0.940; p = 0.000) and possibly lower AD risk (aRR = 0.619; CI = 0.383–1.000; p = 0.050). Lipophilic statins were associated with reduced risk of AD (aRR = 0.639; CI = 0.449–0.908; p = 0.013) but not all-caused dementia (aRR = 0.738; CI = 0.475–1.146; p = 0.176). In conclusion, our meta-analysis suggests that the use of statins may reduce the risk of all-type dementia, AD, and MCI, but not of incident VaD.
Highlights
As the life expectancy is getting longer worldwide, the number of people affected by cognitive decline and dementia is steadily increasing[1]
One meta-analysis had examined a possible effect in reducing the incidence of MCI37 and to our knowledge, no previous meta-analyses has separately assessed the risk of vascular dementia (VaD)
2402 were excluded after title/abstract screening because they are not related to this meta-analysis; the main target of current meta-analysis aimed to discuss the association between statins and dementia
Summary
As the life expectancy is getting longer worldwide, the number of people affected by cognitive decline and dementia is steadily increasing[1]. A meta-analysis including case-control and cohort studies demonstrated statins use did not confer a protective effect on the risk of dementia or AD35. In the most recent study published in 2013, Richardson et al found a reduced RR for all-caused dementia, AD, or MCI based on observational studies, while 16 cohort studies were available when this previous meta-analysis was conducted[37]. The majority of these meta-analyses have focused solely on statins use and the risk of all-caused dementia and AD. The current systematic review and meta-analysis aims to reappraise available evidence from prospective studies, which investigated whether statins use could diminish incident all-caused dementia, AD, VaD, and MCI. Due to the anticipated larger current evidence base, we aimed to explore potential sources of heterogeneity across studies
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