Emily C Kemp1, Megan K Ebner2, Srinath Ramanan2, Tyler A Godek2, Erika A Pugh2, Hugh H Bartlett2, Julia W McDonald2, Marcia C Mecca3, Christopher H van Dyck4, Adam P Mecca2. 1. Alzheimer's Disease Research Unit, Yale University School of Medicine (ECK, MKE, SR, TAG, EAP, HHB, JWM, CHvD, APM), New Haven, CT; Department of Psychiatry, Yale University School of Medicine (ECK, MKE, SR, TAG, EAP, HHB, JWM, CHvD, APM), New Haven, CT. Electronic address: emilyclairekemp@gmail.com. 2. Alzheimer's Disease Research Unit, Yale University School of Medicine (ECK, MKE, SR, TAG, EAP, HHB, JWM, CHvD, APM), New Haven, CT; Department of Psychiatry, Yale University School of Medicine (ECK, MKE, SR, TAG, EAP, HHB, JWM, CHvD, APM), New Haven, CT. 3. Veterans Affairs Connecticut Healthcare System (MCM), West Haven, CT; Department of Internal Medicine, Geriatrics Section, and the Program on Aging, Yale University School of Medicine (MCM), New Haven, CT. 4. Alzheimer's Disease Research Unit, Yale University School of Medicine (ECK, MKE, SR, TAG, EAP, HHB, JWM, CHvD, APM), New Haven, CT; Department of Psychiatry, Yale University School of Medicine (ECK, MKE, SR, TAG, EAP, HHB, JWM, CHvD, APM), New Haven, CT; Department of Neuroscience, Yale University School of Medicine (CHvD), New Haven, CT; Department of Neurology, Yale University School of Medicine (CHvD), New Haven, CT.
Abstract
OBJECTIVE: To investigate associations between statin use and cognitive change, as well as diagnostic conversion, in individuals with cognitively normal (CN) status, mild cognitive impairment (MCI), and dementia due to Alzheimer disease (AD-dementia). METHODS: A multicenter cohort study with 1629 adults 48 to 91 years old with CN status, early MCI (EMCI), late MCI (LMCI), or AD-dementia at baseline followed prospectively for 24 months. Statin use was assessed at baseline, and cognition was measured over time with a composite memory score, a composite executive function score, and a global cognition score (Alzheimer's Disease Assessment Scale). Conversion to a more impaired diagnostic category was determined by clinician assessment. Repeated measures linear mixed-effects models were used to evaluate associations between statin use and change in cognition over time. Cox proportional hazards models were used to evaluate associations between statin use and time to diagnostic conversion. All models were stratified by baseline diagnostic group. RESULTS: Statin use was not associated with change in cognitive measures for CN, LMCI, or AD-dementia participants. Among EMCI participants, statin use was associated with a significantly slower rate of decline on the memory composite, but no other cognitive measure. Statin use was not associated with time to conversion for any diagnostic group. CONCLUSIONS: This study did not support an association between statin use and diagnostic conversion but suggested a possible association between statin use and cognitive change in EMCI. Additional randomized clinical trials of statins may be warranted in the prodromal EMCI stage of AD.
OBJECTIVE: To investigate associations between statin use and cognitive change, as well as diagnostic conversion, in individuals with cognitively normal (CN) status, mild cognitive impairment (MCI), and dementia due to Alzheimer disease (AD-dementia). METHODS: A multicenter cohort study with 1629 adults 48 to 91 years old with CN status, early MCI (EMCI), late MCI (LMCI), or AD-dementia at baseline followed prospectively for 24 months. Statin use was assessed at baseline, and cognition was measured over time with a composite memory score, a composite executive function score, and a global cognition score (Alzheimer's Disease Assessment Scale). Conversion to a more impaired diagnostic category was determined by clinician assessment. Repeated measures linear mixed-effects models were used to evaluate associations between statin use and change in cognition over time. Cox proportional hazards models were used to evaluate associations between statin use and time to diagnostic conversion. All models were stratified by baseline diagnostic group. RESULTS:Statin use was not associated with change in cognitive measures for CN, LMCI, or AD-dementiaparticipants. Among EMCI participants, statin use was associated with a significantly slower rate of decline on the memory composite, but no other cognitive measure. Statin use was not associated with time to conversion for any diagnostic group. CONCLUSIONS: This study did not support an association between statin use and diagnostic conversion but suggested a possible association between statin use and cognitive change in EMCI. Additional randomized clinical trials of statins may be warranted in the prodromal EMCI stage of AD.
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Authors: Neil J Stone; Jennifer G Robinson; Alice H Lichtenstein; C Noel Bairey Merz; Conrad B Blum; Robert H Eckel; Anne C Goldberg; David Gordon; Daniel Levy; Donald M Lloyd-Jones; Patrick McBride; J Sanford Schwartz; Susan T Shero; Sidney C Smith; Karol Watson; Peter W F Wilson; Karen M Eddleman; Nicole M Jarrett; Ken LaBresh; Lev Nevo; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: Z Arvanitakis; J A Schneider; R S Wilson; J L Bienias; J F Kelly; D A Evans; D A Bennett Journal: Neurology Date: 2008-01-16 Impact factor: 9.910