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        Statins May Reduce Dementia Risk By 70 Percent

        A DGReview of :"Statins and the risk of dementia"
        Lancet

        11/10/2000
        By Harvey McConnell


        People over the age of 50 who are prescribed cholesterol-lowering drugs known as statins may reduce by 70 percent their risk of developing dementia.

        Researchers, Dr. Hershel Jick and colleagues from the Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, in collaboration with Dr David Drachman, the University of Massachusetts Medical School, acknowledged the immediate impact with publication of their epidemiological study of the potential effect of statins and other lipid-lowering agents (LLAs) on dementia.

        Dr. Jick said of their report: "If substantiated, the implications of this observational study are considerable. These findings suggest that the use of statins could substantially reduce the risk of dementia in the elderly, either by delaying its onset, or by opposing specific or general age-related changes that result in cognitive impairment.

        "We are aware of the substantial potential consequences of this publication, and that our data should be replicated by additional studies. Given the potential impact of this study, additional studies of acceptable quality are urgently needed."

        Researchers point out that dementia affects an estimated 10 percent of people over the age of 65. Vascular and lipid-related mechanisms are thought to have a role in the pathogenesis of Alzheimer's disease and vascular dementia.

        Using a nested case control study based on information gathered from 388 family practices in the British-based General Practice Research Database, an epidemiological study was made of the potential effect of HMGCoA (3 hydroxy-3methylglutaryl-coenzyme A) reductase inhibitors (statins) and other lipid-lowering agents on dementia.

        The base study population included three groups of patients aged 50 and over who had received lipid-lowering agents (LLAs), and who had a clinical diagnosis of untreated hyperlipidaemia plus a randomly selected group of other patients.

        All cases with a clinical diagnosis of dementia were identified from this base population. Each case was matched with up to four controls derived from the base population for age, sex, practice, and index date of case. The study encompassed 284 cases with dementia and 1 080 matched controls.

        Among controls, 13 percent had untreated hyperlipidaemia, 11 percent were prescribed statins, seven percent received other LLAs, and 69 percent had no hyperlipidaemia or LLA exposure.

        Patients prescribed statins were around 70 percent less likely to have dementia compared with people who had no diagnosis of hyperlipidaemia or exposure to other lipid-lowering drugs. Patients treated with other LLAs, and individuals with untreated hyperlipidaemia, did not have a significantly reduced risk of dementia.

        "We determined the relative risk for dementia in the group diagnosed as 'dementia' as compared with those diagnosed as 'Alzheimer's disease', and found no material difference in effect," Dr. Jick and his collaborators report. "This suggests that there may be a common risk factor for dementia related to the effect of statins."
        "Statins and the risk of dementia"

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