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Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults
Zhou Z, Ryan J, Ernst ME, Zoungas S, Tonkin AM, Woods RL, McNeil JJ, Reid CM et al.. Journal of the American College of Cardiology, 2021-06-01
Topic: Risk, prevention and care in population studies
Plain-language summary
Background The neurocognitive effect of statins in older adults remain uncertain. Objectives The aim of this study was to investigate the associations of statin use with cognitive decline and incident dementia among older adults. Methods This analysis included 18,846 participants ≥65 years of age in a randomized trial of aspirin, who had no prior cardiovascular events, major physical disability, or dementia initially and were followed for 4.7 years. Outcome measures included incident dementia and its subclassifications (probable Alzheimer's disease, mixed presentations); mild cognitive impairment (MCI) and its subclassifications (MCI consistent with Alzheimer's disease, other MCI); and changes in domain-specific cognition, including global cognition, memory, language and executive function, psychomotor speed, and the composite of these domains. Associations of baseline statin use versus nonuse with dementia and MCI outcomes were examined using Cox proportional hazards models and with cognitive change using linear mixed-effects models, adjusting for potential confounders. The impact of statin lipophilicity on these associations was further examined, and effect modifiers were identified. Results Statin use versus nonuse was not associated with dementia, MCI, or their subclassifications or with changes in cognitive function scores over time (p > 0.05 for all). No differences were found in any outcomes between hydrophilic and lipophilic statin users. Baseline neurocognitive ability was an effect modifier for the associations of statins with dementia (p for interaction < 0.001) and memory change (p for interaction = 0.02). Conclusions In adults ≥65 years of age, statin therapy was not associated with incident dementia, MCI, or declines in individual cognition domains. These findings await confirmation from ongoing randomized trials.
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APA 7th
Zhou, Z., Ryan, J., Ernst, M. E., Zoungas, S., Tonkin, A. M., Woods, R. L., et al. (2021). Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2021.04.075
Vancouver
Zhou Z, Ryan J, Ernst ME, Zoungas S, Tonkin AM, Woods RL, et al. Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults. Journal of the American College of Cardiology. 2021. doi:10.1016/j.jacc.2021.04.075. PMID: 34167639.
BibTeX
@article{zhou2021-34167639,
author = {Zhou, Z. and Ryan, J. and Ernst, M. E. and Zoungas, S. and Tonkin, A. M. and Woods, R. L. and McNeil, J. J. and Reid, C. M. and others},
title = {{Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults}},
journal = {Journal of the American College of Cardiology},
year = {2021},
doi = {10.1016/j.jacc.2021.04.075},
pmid = {34167639},
url = {https://doi.org/10.1016/j.jacc.2021.04.075}
}
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Key findings
- Associations of baseline statin use versus nonuse with dementia and MCI outcomes were examined using Cox proportional hazards models and with cognitive change using linear mixed-effects models, adjusting for potential confounders.
- Results Statin use versus nonuse was not associated with dementia, MCI, or their subclassifications or with changes in cognitive function scores over time (p > 0.05 for all).
- Conclusions In adults ≥65 years of age, statin therapy was not associated with incident dementia, MCI, or declines in individual cognition domains.
- These findings await confirmation from ongoing randomized trials.
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Study details
- Study designrandomized controlled trial
- Participants18,846
- Effect sizeor 4.7
- Evidence strengthHigh
How this study scored 83/100
Published in a peer-reviewed journal, and it is a randomized controlled trial. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 48 of the 58 points we could judge it on, which is 83 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American College of Cardiology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 11 / 12 | A randomized controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 4 / 4 | 18,846 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 1 / 2 | Randomized (as stated in the record) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 34167639) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 48 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 48 of the 58 points we could judge it on is 83 out of 100. |
| Total | 83 / 100 | — |
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