Article Abstract

Overview the effect of statin therapy on dementia risk, cognitive changes and its pathologic change: a systematic review and meta-analysis

Authors: Xi-Chen Zhu, Wen-Zhuo Dai, Tao Ma


Background: Many studies have reported on the role of statin therapy in dementia, but its efficacy remains controversial. We aimed to search for reliable and meaningful articles to assess the efficacy of statin therapy for dementia risk, cognitive items, and pathologic markers.
Methods: Related literature for this study was published in the period from January 1, 1987 to January 1, 2018. Odds ratio (OR) and 95% confidence interval (95% CI) estimates were pooled in either fixed or random effects models.
Results: A total of 23 relevant studies were included after the application of the search strategy. The pooled results showed that statin therapy would downregulate dementia risk according to an analysis of 1,314,431 dementia patients and 1,836,539 healthy controls (OR: 0.64, 95% CI: 0.50, 0.81). In addition, specific changes in mini-mental state examination (MMSE) score were observed in individuals with dementia with statin therapy (OR: 0.46, 95% CI: 0.17, 0.74). However, the results of this meta-analysis showed that statin therapy did not significantly modify the Alzheimer’s Disease Assessment Scale (ADAS-cog) score (OR: −0.26, 95% CI: −1.13, 0.62). No significant association was found between statin therapy and activities of daily living performance (OR: −0.69, 95% CI: −4.12, 2.74). When investigating pathological markers, our results indicated a significant influence of statin therapy on plasma amyloid β40 (Aβ40) (OR: 9.27, 95% CI: 0.71, 17.84), plasma Aβ42 (OR: 2.60, 95% CI: 1.07, 4.13), plasma low-density lipoprotein (LDL) cholesterol (OR: −16.95, 95% CI: −25.54, −8.37), plasma lathosterol (OR: −0.11, 95% CI: −0.14, −0.07), plasma 24s-hydroxycholesterol (OR: −10.41, 95% CI: −15.57, −5.25), and cerebrospinal fluid (CSF) lathosterol (OR: −0.07, 95% CI: −0.12, −0.01).
Conclusions: The available data indicate that statin therapy may reduce dementia risk, altering cognitive items and pathologic markers.