Statins for the treatment of dementia.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 25004278 · doi:10.1002/14651858.CD007514.pub3
What was done
Authors conducted a Cochrane systematic review and meta-analysis of double-blind, randomised controlled trials assessing statins administered for at least six months to individuals with dementia. Searches spanned ALOIS, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS, and trials registries through January 20, 2014. Two independent authors evaluated study eligibility, extracted data, assessed risk of bias, and pooled outcomes.
What was found
Four studies (1,154 participants, age range 50 to 90 years) with probable or possible Alzheimer's disease were identified; most took cholinesterase inhibitors. Pooled analyses showed no statistically significant benefit from statins on: - Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-Cog): mean difference -0.26 (95% CI -1.05 to 0.52, P = 0.51; 4 studies) - Mini Mental State Examination (MMSE): mean difference -0.32 (95% CI -0.71 to 0.06, P = 0.10; 4 studies) - Treatment-related adverse effects: odds ratio 1.09 (95% CI 0.58 to 2.06, P = 0.78; 3 studies) - Behaviour, global function, or activities of daily living (no significant difference reported). All studies had a low risk of bias. No studies evaluated statins for vascular dementia.
Why it matters
Despite hypotheses linking cholesterol metabolism to amyloid plaque deposition, statin therapy does not improve cognitive or functional outcomes in established Alzheimer's disease.
Limits
The analysis is restricted to four trials (1,154 total participants). No studies evaluated patients with vascular dementia, and the abstract provides no subgroup findings regarding cholesterol levels, ApoE genotype, or cognitive baseline.
Cited by
- supports There has never been a clinical study evaluating statin use that had the incidence of Alzheimer's disease or dementia as a primary outcome.