Kun Xuan1, Tianming Zhao1, Guangbo Qu1, Haixia Liu1, Xin Chen1, Yehuan Sun2,3. 1. Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. 2. Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. yhsun_ahmu_edu@yeah.net. 3. Center for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China. yhsun_ahmu_edu@yeah.net.
Abstract
OBJECTIVE: Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden, and the using of statins to treat AD has caused widely debated. The purpose of this meta-analysis is to explore the effect of statins in the treatment of Alzheimer's disease. METHODS: Studies were retrieved by searching PubMed, Embase, Cochrane library, OvisdSP, Web of Science, Chinese Nation Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases before March 31, 2019. We extracted the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Neuropsychiatric Inventory (NPI), Activities of Daily Living (ADL) scale score, and other information. The pooled Weighted Mean Difference (WMD) and their 95% confidence intervals (95% CI) were calculated with random effect model or fixed random effect model. RESULTS: A total of nine randomized controlled trials were included that contained 1489 patients; of them, 742 patients in the statins group, 747 patients in the control group. There were nine studies used the MMSE scale, five studies used the ADAS-Cog scale, four studies used the NPI scale, and six studies used the ADL scale. Meta-analysis of the nine studies that reported the MMSE scale scores indicated that there is no significant effect of statins as compared with control group (the pooled WMD = 1.09, 95% CI, - 0.00, 2.18, p = 0.05, I2 = 87.9%). Meta-analysis of the five studies that reported the ADAS-Cog scale scores also indicated that there is no significant effect of statins as compared with control group (the pooled WMD = - 0.16, 95% CI, - 2.67, 2.36, p = 0.90, I2 = 80.1%). Meta-analysis of the four studies that reported the NPI scale scores indicated that treatment with statins could slow the rise in the NPI scale scores (the pooled WMD = - 1.16, 95% CI, - 1.88, - 0.44, p = 0.002, I2 = 45.4%). Meta-analysis of the six studies that reported the ADL scale scores indicated that treatment with statins could improve patients' daily living ability (the pooled WMD = - 4.06, 95% CI, - 6.88, - 1.24, p = 0.005, I2 = 86.7%). Results of subgroup analysis indicated that the use of statins in the short term (≤ 12 months) associated with the change of the MMSE scale scores (the pooled WMD = 1.78, 95% CI, 0.53, 3.04, p = 0.005, I2 = 79.6%). Sensitivity analysis and publication bias test were both negative, and the results were relatively reliable and stable. CONCLUSION: Statins used in AD patients had beneficial effects on the scores of MMSE scale in the short term (≤ 12 months), and statins could slow the deterioration of neuropsychiatric status and significantly improve activities of daily living ability in AD patients, but statins did not show an advantage in the change of the ADAS-Cog scale scores.
OBJECTIVE:Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden, and the using of statins to treat AD has caused widely debated. The purpose of this meta-analysis is to explore the effect of statins in the treatment of Alzheimer's disease. METHODS: Studies were retrieved by searching PubMed, Embase, Cochrane library, OvisdSP, Web of Science, Chinese Nation Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases before March 31, 2019. We extracted the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Neuropsychiatric Inventory (NPI), Activities of Daily Living (ADL) scale score, and other information. The pooled Weighted Mean Difference (WMD) and their 95% confidence intervals (95% CI) were calculated with random effect model or fixed random effect model. RESULTS: A total of nine randomized controlled trials were included that contained 1489 patients; of them, 742 patients in the statins group, 747 patients in the control group. There were nine studies used the MMSE scale, five studies used the ADAS-Cog scale, four studies used the NPI scale, and six studies used the ADL scale. Meta-analysis of the nine studies that reported the MMSE scale scores indicated that there is no significant effect of statins as compared with control group (the pooled WMD = 1.09, 95% CI, - 0.00, 2.18, p = 0.05, I2 = 87.9%). Meta-analysis of the five studies that reported the ADAS-Cog scale scores also indicated that there is no significant effect of statins as compared with control group (the pooled WMD = - 0.16, 95% CI, - 2.67, 2.36, p = 0.90, I2 = 80.1%). Meta-analysis of the four studies that reported the NPI scale scores indicated that treatment with statins could slow the rise in the NPI scale scores (the pooled WMD = - 1.16, 95% CI, - 1.88, - 0.44, p = 0.002, I2 = 45.4%). Meta-analysis of the six studies that reported the ADL scale scores indicated that treatment with statins could improve patients' daily living ability (the pooled WMD = - 4.06, 95% CI, - 6.88, - 1.24, p = 0.005, I2 = 86.7%). Results of subgroup analysis indicated that the use of statins in the short term (≤ 12 months) associated with the change of the MMSE scale scores (the pooled WMD = 1.78, 95% CI, 0.53, 3.04, p = 0.005, I2 = 79.6%). Sensitivity analysis and publication bias test were both negative, and the results were relatively reliable and stable. CONCLUSION:Statins used in ADpatients had beneficial effects on the scores of MMSE scale in the short term (≤ 12 months), and statins could slow the deterioration of neuropsychiatric status and significantly improve activities of daily living ability in ADpatients, but statins did not show an advantage in the change of the ADAS-Cog scale scores.
Authors: Mark R Goldstein; Luca Mascitelli; Francesca Pezzetta; M N Haan; C Cramer; J Kalbfleisch; K Langa; S Galea Journal: Neurology Date: 2009-03-31 Impact factor: 9.910
Authors: James Shepherd; Gerard J Blauw; Michael B Murphy; Edward L E M Bollen; Brendan M Buckley; Stuart M Cobbe; Ian Ford; Allan Gaw; Michael Hyland; J Wouter Jukema; Adriaan M Kamper; Peter W Macfarlane; A Edo Meinders; John Norrie; Chris J Packard; Ivan J Perry; David J Stott; Brian J Sweeney; Cillian Twomey; Rudi G J Westendorp Journal: Lancet Date: 2002-11-23 Impact factor: 79.321
Authors: Kit Yee Chan; Wei Wang; Jing Jing Wu; Li Liu; Evropi Theodoratou; Josip Car; Lefkos Middleton; Tom C Russ; Ian J Deary; Harry Campbell; Wei Wang; Igor Rudan Journal: Lancet Date: 2013-06-08 Impact factor: 79.321
Authors: Teodor T Postolache; Deborah R Medoff; Clayton H Brown; Li Juan Fang; Sanjaya K Upadhyaya; Christopher A Lowry; Michael Miller; Julie A Kreyenbuhl Journal: Pteridines Date: 2021-09-23 Impact factor: 0.581