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2017 ; 9
(7
): 638-649
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Association of Cognitive Impairment in Patients on
3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitors
#MMPMID28611866
Roy S
; Weinstock JL
; Ishino AS
; Benites JF
; Pop SR
; Perez CD
; Gumbs EA
; Rosenbaum JA
; Roccato MK
; Shah H
; Contino G
; Hunter K
J Clin Med Res
2017[Jul]; 9
(7
): 638-649
PMID28611866
show ga
BACKGROUND: Atherosclerotic cardiovascular diseases are the leading cause of
death in the United States. A reduction in cholesterol with
3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (statin) significantly
reduces mortality and morbidity. Statins may be associated with cognitive
impairment or dementia. Our aim was to study the association of cognitive
impairment or dementia in patients who were on a statin. METHODS: Electronic
medical records of 3,500 adult patients in our suburban internal medicine office
were reviewed. RESULTS: There were 720 (20.6%) patients in the statin treatment
group. Dementia or cognitive impairment was an associated comorbid condition in
7.9% patients in the statin treatment group compared to 3.1% patients in the
non-statin group (P < 0.001). Analysis of all of the patients with cognitive
impairment or dementia showed that among the age ranges of 51 years through 100
years, the patients in the statin treatment group had a higher prevalence of
cognitive impairment or dementia compared to the non-statin group. In the statin
treatment group, we found significantly higher prevalence of hyperlipidemia
(86.3%), hypertension (69.6%), diabetes mellitus (36.0%), osteoarthritis (31.5%),
coronary artery disease (26.1%), hypothyroidism (21.5%) and depression (19.3%)
compared to the non-statin group (P < 0.001). About 39.9% of the patients with
dementia or cognitive impairment were on statin therapy compared to 18.9%
patients who had no dementia or cognitive impairment and were on statin therapy
(P < 0.001). Among the patients with cognitive deficit or dementia in the statin
treatment group, the majority of the patients were either on atorvastatin (43.9%)
or simvastatin (35.1%), followed by rosuvastatin (12.2%) and pravastatin (8.8%).
We found greater odds of dementia or cognitive impairment with each year increase
in age (1.3 times), in women (2.2 times), African American race (2.7 times),
non-consumption of moderate amount of alcohol (two times), diabetes mellitus (1.6
times), hypothyroidism (1.7 times), cerebrovascular accident (3.2 times), and
other rheumatological diseases (1.8 times). CONCLUSIONS: The association of
dementia or cognitive impairment was significantly higher in the patients who
were on statin therapy compared to the patients who were not on a statin.
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