Tsung-Kun Lin1,2, Lung-Fa Pan3,4, Jing-Yang Huang5,6, Gwo-Ping Jong7. 1. Department of Pharmacy, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China. 2. School of Pharmacy, National Defense Medical Center, Taipei, Taiwan, Republic of China. 3. Graduate Institute of Radiological Science, Central Taiwan University of Science and Technology, Takun, Taichung, Taiwan, Republic of China. 4. Department of Cardiology, Taichung Armed Forces General Hospital, Taichung, Taiwan, Republic of China. 5. Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China. 6. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China. 7. Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung, Taiwan, Republic of China. cgp8009@yahoo.org.tw.
Abstract
BACKGROUND: Some observational studies have found a significant association between the use of statin and a reduced risk of dementia. However, the results of these studies are unclear in patients with rheumatoid arthritis (RA). This study is to determine the association between the use of statins and the incidence of dementia according to sex and age-related differences in patients with RA. METHODS: We conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2003-2016). The primary outcome assessed was the risk of dementia by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was used to estimate the adjusted hazard ratio of new-onset dementia. Subgroup analysis was also conducted. RESULTS: Among the 264,036 eligible patients with RA aged > 40 years, statin users were compared with non-statin users by propensity score matching at a ratio of 1:1 (25,764 in each group). However, no association was found between the use of statins and the risk of new-onset dementia (NOD) in patients with RA (HR: 1.01; 95% CI: 0.97-1.06). The subgroup analysis identified the use of statin as having a protective effect against developing NOD in male and older patients. CONCLUSION: No association was observed between the use of a statin and the risk of NOD in patients with RA, including patients of both genders and aged 40-60 years, but these parameters were affected by gender and age. The decreased risk of NOD in patients with RA was greater among older male patients. Use of a statin in older male (> 60 years) patients with RA may be needed in clinical practice to prevent dementia.
BACKGROUND: Some observational studies have found a significant association between the use of statin and a reduced risk of dementia. However, the results of these studies are unclear in patients with rheumatoid arthritis (RA). This study is to determine the association between the use of statins and the incidence of dementia according to sex and age-related differences in patients with RA. METHODS: We conducted a nationwide retrospective cohort study using the Taiwan Health Insurance Review and Assessment Service database (2003-2016). The primary outcome assessed was the risk of dementia by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was used to estimate the adjusted hazard ratio of new-onset dementia. Subgroup analysis was also conducted. RESULTS: Among the 264,036 eligible patients with RA aged > 40 years, statin users were compared with non-statin users by propensity score matching at a ratio of 1:1 (25,764 in each group). However, no association was found between the use of statins and the risk of new-onset dementia (NOD) in patients with RA (HR: 1.01; 95% CI: 0.97-1.06). The subgroup analysis identified the use of statin as having a protective effect against developing NOD in male and older patients. CONCLUSION: No association was observed between the use of a statin and the risk of NOD in patients with RA, including patients of both genders and aged 40-60 years, but these parameters were affected by gender and age. The decreased risk of NOD in patients with RA was greater among older male patients. Use of a statin in older male (> 60 years) patients with RA may be needed in clinical practice to prevent dementia.
Authors: Jon T Einarsson; Minna Willim; Sofia Ernestam; Tore Saxne; Pierre Geborek; Meliha C Kapetanovic Journal: Rheumatology (Oxford) Date: 2019-02-01 Impact factor: 7.580
Authors: Irene Tramacere; Giorgio B Boncoraglio; Rita Banzi; Cinzia Del Giovane; Koren H Kwag; Alessandro Squizzato; Lorenzo Moja Journal: BMC Med Date: 2019-03-26 Impact factor: 8.775
Authors: Shige Qi; Peng Yin; Han Zhang; Qingjun Zhang; Yize Xiao; Ying Deng; Zhong Dong; Yan Shi; Jun Meng; Dantao Peng; Zhihui Wang Journal: Front Public Health Date: 2021-11-02