Statin therapy and risk of dementia in the elderly: a community-based prospective cohort study
Li G, Higdon R, Kukull WA, Peskind E, Van Valen Moore K, Tsuang D, van Belle G, McCormick W et al.. Neurology, 2004-11-01
Topic: Risk, prevention and care in population studies
Plain-language summary
Objective To assess the association between statin therapy and risk of Alzheimer disease (AD) in a prospective cohort study with documented statin exposure and incident dementia. Methods This is a prospective, cohort study of statin use and incident dementia and probable AD. A cohort of 2,356 cognitively intact persons, aged 65 and older, were randomly selected from a health maintenance organization (HMO), and were assessed biennially for dementia. Statin use was identified using the HMO pharmacy database. A proportional hazards model with statin use as a time-dependent covariate was used to assess the statin-dementia/AD association. Results Among 312 participants with incident dementia, 168 had probable AD. The unadjusted hazard ratios (HRs) with statin use were 1.33 (95% CI 0.95 to 1.85) for all-cause dementia and 0.90 (CI 0.54 to 1.51) for probable AD. Adjusted corresponding HRs were 1.19 (CI 0.82 to 1.75) and 0.82 (CI 0.46 to 1.46). A subgroup analysis of participants with at least one APOE-epsilon4 allele who entered the study before age 80 produced an adjusted HR of 0.33 (CI 0.10 to 1.04). Conclusion Employing time-dependent proportional hazards modeling, the authors found no significant association between statin use and incident dementia or probable AD. In contrast, when the data were analyzed, inappropriately, as a case-control study, the authors found an OR of 0.55 for probable AD, falsely indicating a protective effect of statins. Study design and analytic methods may explain the discrepancy between the current null findings and earlier findings.
What this study adds
Evidence grade: Moderate
This is a follow-up (cohort) study of 312 participants. In this community cohort, statin use was not significantly associated with the risk of developing dementia or probable Alzheimer's disease. The authors note that an apparent protective effect appeared only when the data were analyzed in a way they describe as inappropriate.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Li, G., Higdon, R., Kukull, W. A., Peskind, E., Van Valen Moore, K., Tsuang, D., et al. (2004). Statin therapy and risk of dementia in the elderly: a community-based prospective cohort study. Neurology. https://doi.org/10.1212/01.wnl.0000142963.90204.58
Vancouver
Li G, Higdon R, Kukull WA, Peskind E, Van Valen Moore K, Tsuang D, et al. Statin therapy and risk of dementia in the elderly: a community-based prospective cohort study. Neurology. 2004. doi:10.1212/01.wnl.0000142963.90204.58. PMID: 15534246.
BibTeX
@article{li2004-15534246,
author = {Li, G. and Higdon, R. and Kukull, W. A. and Peskind, E. and Van Valen Moore, K. and Tsuang, D. and van Belle, G. and McCormick, W. and others},
title = {{Statin therapy and risk of dementia in the elderly: a community-based prospective cohort study}},
journal = {Neurology},
year = {2004},
doi = {10.1212/01.wnl.0000142963.90204.58},
pmid = {15534246},
url = {https://doi.org/10.1212/01.wnl.0000142963.90204.58}
}
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Key findings
- Results Among 312 participants with incident dementia, 168 had probable AD.
- Conclusion Employing time-dependent proportional hazards modeling, the authors found no significant association between statin use and incident dementia or probable AD.
Why it matters
In this community cohort, statin use was not significantly associated with the risk of developing dementia or probable Alzheimer's disease. The authors note that an apparent protective effect appeared only when the data were analyzed in a way they describe as inappropriate.
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Study details
- Study designcohort study
- Participants312
- Evidence strengthModerate
How this study scored 63/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — older than 20 years, still counted |
| Sample size | 2 / 4 | 312 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 246 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.2 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 4 / 6 | Cited 14.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 15 other studies in this library |
| Still being cited | 1 / 4 | Cited 12 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Eric B. Larson: h-index 63 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15534246) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 63 / 100 | — |
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