Statin may be more harmful than beneficial in people with dementia

For individuals with dementia, statin use does not appear to provide cardioprotective benefits but rather contributes to an increased risk of hospitalization due to cardiovascular or cerebrovascular events, according to a retrospective study.

The study included 96,162 nursing home residents, of which 58,900 had dementia and 37,262 had no dementia. Propensity score-based models were used to assess the association between statin use and hospitalizations due to cerebrovascular and cardiovascular events.

Statin use was associated with a 6-percent increased risk of hospitalization due to cardiovascular or cerebrovascular events among participants with dementia (hazard ratio [HR], 1.06, 95 percent confidence interval [CI], 1.01–1.12; p=0.023). The risk further increased with aggressive statin use: a 15-percent risk increase with moderate statin intensity (HR, 1.15, 95 percent CI, 1.07–1.23; p<0.001) and 55-percent risk increase with high statin intensity (HR, 1.55, 95 percent CI, 1.15–2.10; p=0.005)

In subgroup analyses, the association between statin use and increased risk of hospitalization was especially pronounced among participants without atherosclerotic cardiovascular disease (HR, 1.30, 95 percent CI, 1.12–1.52; p<0.001), those with vascular dementia (HR, 1.18, 95 percent CI, 1.06–1.32; p=0.003) and Alzheimer’s disease (HR, 1.14, 95 percent CI, 1.00–1.31; p=0.047), and those with newly prescribed statins (HR, 2.71, 95 percent CI, 2.33–3.15; p<0.001).

Among participants without dementia, statin use had a null effect on the risk of hospitalization (HR, 1.03, 95 percent CI, 0.96–1.11; p=0.397). However, a risk increase was observed among those who were using high-intensity statins (HR, 1.51, 95 percent CI, 1.04–2.19; p=0.029) and those with newly prescribed statins (HR, 1.99, 95 percent CI, 1.56–2.52).

The present data underscore consideration of statin use in people with dementia.