Do cholesterol lowering drugs help prevent dementia?

The Bottom Line

  • Statins are drugs that lower cholesterol and help reduce heart disease. They are among the most prescribed types of medication.
  • While some researchers believe heart health and Alzheimer's disease may be linked, current research shows that statin medications do not reduce the chance of getting dementia.

If you’re taking pills to lower your cholesterol, you’re not alone. “Statins” – drugs that work by inhibiting a certain enzyme in the liver that produces cholesterol – are among the top three most prescribed medications in North America (1;2) with a healthcare price tag of close to $2 billion annually in Canada alone (3).


With names like atorvastatin (Lipitor®) and rosuvastatin (Crestor®) the drugs’ ultimate purpose is to lower the risk of heart attack and stroke. They are generally “well tolerated,” meaning the majority of people don’t have problems taking them (4;5). And recent research suggested that statins may have another benefit: lowering the risk of dementia.


With the number of people with dementia already at an alarming high and predicted to double every 20 years (6), getting Alzheimer’s or a related disease has become one of our greatest health fears. A pill that wards off both heart disease and dementia would definitely be a “two-for-one” deal worth getting excited about!


But do statins really help to prevent dementia?


What the research tells us

Observational studies have produced mixed results: a few early studies reported a significant preventative benefit (7;8) but others since were much less encouraging. Large-scale randomized controlled trials are challenging for such a complex topic, but the authors of a recent systematic review found two, involving a total of 26,340 participants aged 40 to 82, almost half of them age 70 and over (9). They were given one of two different statins, monitored and assessed over a three to five year follow-up period, and compared with people in control groups who were given a placebo.


What did they find? Disappointingly, there was no evidence that statins have any effect in preventing cognitive decline or dementia (9).


If your doctor has prescribed statins, take them. And while you’re at it, take any advice offered about lifestyle changes including diet and exercise. The pills alone may not be a magic solution for avoiding dementia but maintaining a strong, healthy heart and body will always have benefits.

Featured Resources

  1. Blog Post: Dementia care 
  2. Web Resource Rating: Dementia: Topic overview 
  3. Web Resource Rating: Statins

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References

  1. Hing E, Rui P, and Palso K. National ambulatory medical care survey: 2013 State and national summary tables [Internet]. Centre for Disease Control; 2013. Available from:  https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2013_namcs_web_tables.pdf
  2. Rotermann M, Sanmartin C, Hennessy D, et al. Prescription medication use by Canadians aged 6 to 79 [Internet]. Statistics Canada; 2014. Available from: https://www.statcan.gc.ca/pub/82-003-x/2014006/article/14032-eng.htm
  3. Morgan S, Smolina K, Mooney D, et al. The Canadian Rx Atlas. Vancouver: Centre for Health Services and Policy Research; 2013.
  4. Finegold JA, Manisty CH, Goldacre B, et al. What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice. Eur J Prev Cardiol. 2014;21:464-74.
  5. Taylor F, Huffman MD, Macedo AF, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013(1):CD004816.
  6. Prince M, Wimo A, Guerchet M, et al. World Alzheimer Report 2015 [Internet]. London: Alzheimer’s Disease International; 2015. Available from: https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf 
  7. Jick H, Zornberg GL, Jick SS et al. Statins and the risk of dementia. Lancet. 2000; 356:1627–31.
  8. Wolozin B, Kelllman W, Ruosseau P et al. Decreased prevalence of Alzheimer disease associated with 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors. Archives of Neurology 2000; 57:1439-43.
  9. McGuinness B, Craig D, Bullock R et al. Statins for the prevention of dementia. Cochrane Database Syst Rev. 2016; (1):CD003160.

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