Statins for the treatment of dementia

. 2014 Jul 8;2014(7):CD007514. doi: 10.1002/14651858.CD007514.pub3

Study	Reason for exclusion
Gutterman 2002	Post‐hoc analysis from randomised placebo‐controlled clinical trials of galantamine in patients with AD. Not sufficiently powered according to authors to examine the effects of statins on cognition. Using last observation carried forward, mean ADAS‐Cog change from baseline was measured. Of 1311 patients, 8.8% were taking statins. There were 4 treatment groups: placebo (598 participants), galantamine alone (598 participants), statin alone (60 participants) and galantamine plus statin (55 participants). While galantamine use was associated with a significant change in mean ADAS‐Cog from baseline (P value < 0.001), statin use (P value = 0.195) or the interaction of galantamine with statins (P value = 0.372) were not. The conclusion was the use of statins did not lead to significant improvement of cognitive function among patients with AD either alone or in combination with galantamine. Longer periods of statin treatment were advised by authors
Winblad 2007	Post‐hoc analysis from randomised placebo‐controlled clinical trials of galantamine in patients with AD. Not sufficiently powered according to authors to establish a 2‐point difference in ADAS‐Cog/11 scale over the study period, which would be clinically significant. Results based on a non‐random sample of pooled participants with regards to statin use, resulting in baseline differences between the statin and non‐statin treatment groups with respect to age and gender. Administration of statins was heterogeneous with respect to specific statin, dose and treatment duration. There were 4 treatment groups: statin plus galantamine (42 participants), statin alone (50 participants), galantamine alone (614 participants) and neither galantamine nor statin (619 participants). While galantamine was associated with a significant beneficial effect on cognitive status (P value < 0.001), there was no association seen with use of statins (P value = 0.083). There was no significant effect on cognition with use of statin plus galantamine (P value = 0.183)

Study

Reason for exclusion

Gutterman 2002

Post‐hoc analysis from randomised placebo‐controlled clinical trials of galantamine in patients with AD. Not sufficiently powered according to authors to examine the effects of statins on cognition. Using last observation carried forward, mean ADAS‐Cog change from baseline was measured. Of 1311 patients, 8.8% were taking statins. There were 4 treatment groups: placebo (598 participants), galantamine alone (598 participants), statin alone (60 participants) and galantamine plus statin (55 participants). While galantamine use was associated with a significant change in mean ADAS‐Cog from baseline (P value < 0.001), statin use (P value = 0.195) or the interaction of galantamine with statins (P value = 0.372) were not. The conclusion was the use of statins did not lead to significant improvement of cognitive function among patients with AD either alone or in combination with galantamine. Longer periods of statin treatment were advised by authors

Winblad 2007

Post‐hoc analysis from randomised placebo‐controlled clinical trials of galantamine in patients with AD. Not sufficiently powered according to authors to establish a 2‐point difference in ADAS‐Cog/11 scale over the study period, which would be clinically significant. Results based on a non‐random sample of pooled participants with regards to statin use, resulting in baseline differences between the statin and non‐statin treatment groups with respect to age and gender. Administration of statins was heterogeneous with respect to specific statin, dose and treatment duration. There were 4 treatment groups: statin plus galantamine (42 participants), statin alone (50 participants), galantamine alone (614 participants) and neither galantamine nor statin (619 participants). While galantamine was associated with a significant beneficial effect on cognitive status (P value < 0.001), there was no association seen with use of statins (P value = 0.083). There was no significant effect on cognition with use of statin plus galantamine (P value = 0.183)

AD: Alzheimer's disease; ADAS‐Cog: Alzheimer's Disease Assessment Scale ‐ cognitive subscale.