Table 1.
Characteristics of included studies.
| Author (year) | Criteria | Study design | Mean age (SD) Male (%) |
Subjects (case by statins use or total)* |
Follow up (years) |
Outcome* | Definition of statins use |
Confirm statins use |
Dropouts (%) |
|---|---|---|---|---|---|---|---|---|---|
| Harding (2017)35 | MCIa | Prospective cohort | 69.7 0 |
175(SU/NSU: 3/14) | 8.4 | MCI | Any use | Self-reported | n/a |
| Chitnis (2015)39 | ICD-9 | Retrospective cohort | 74.4 (9.2) 47 |
8062 (SU/NSU: 512/623) | 3 | Dementia | Current use >15 days during month |
EMRe | n/a |
| Hendrie (2015)40 | DSM-IV ICD-10 |
Prospective cohort | 76.6 (4.9) 30.3 |
974 (Dementia, SU/NSU: 9/56); 965 (AD, SU/NSU: 7/49) |
8 | Dementia; AD |
Any use | Medication inspection | n/a |
| Chen (2014)37 | DSM-IV | Retrospective cohort | 66.8 (8.6) 52.3 |
18170 (Dementia, SU/NSU: 53/824); 18013 (AD, SU/NSU: 41/679) |
8 | Dementia; AD |
Regular use (more than one year) | EMRf | n/a |
| Ancelin (2012)18 | DSM-IV NINCDS-ADRDA |
Prospective cohort | 74 40 |
6830 (Dementia, 483; AD, 332) | 7 | Dementia; AD |
Use at baseline | Medication inspection | n/a |
| Bettermann (2012)8 | n/a | Prospective cohort | 78.6 (3.3) 54 |
2587 (Dementia, 324; AD, 212; VaD, 148) | 6 | Dementia; AD; VaD |
Any use | Medication inspection | n/a |
| Beydoun (2011)41 | DSM-III-R NINCDS-ADRDA Petersen criteria |
Prospective cohort | 58.0 (18) 62 |
1604 (Dementia, 259); 1308 (MCI, 133) |
25 | Dementia; AD; MCI |
Ever use | Medication inspection | n/a |
| Parikh (2011)43 | n/a | Retrospective cohort |
75.5 (6.1) 98 |
377838 (SU/NSU: 5316/9246) | 2 | Dementia | Any use (through study) | Pharmacy records | n/a |
| Hippisley-Cox (2010)42 | n/a | Prospective cohort | 45.8 (14.1) 45 |
2004692 (8784) | Up to 6 | Dementia | New users | EMRg | n/a |
| Li (2010)13 | DSM-IV NINCDS-ADRDA |
Prospective cohort | 75.4 (6.2) 40.7 |
3099 (263) | 6.1 | AD | Any use (3 consecutive) | Pharmacy records | 8% |
| Haag (2009)10 | DSM-III-R NINCDS-ADRDA |
Prospective cohort | 69.4 (9.1) 40 |
6992 (466) | 9 | AD | Any use | Pharmacy records | n/a |
| Solomon (2009)45 | n/a | Prospective cohort |
71.8 (4.9) 46.3 |
14294 (1301) | 20 | Dementia | n/a | EMRh | n/a |
| Schneider (2009)44 | MCIb | Prospective cohort | 70 to 80 0 |
293 (n/a) | 3 | MCI | Continuous use (2 consecutive) | n/a | n/a |
| Arvanitakis (2008)19 | n/a | Prospective cohort | 74.9 (7.0) 31.3 |
929 (SU/NSU:: 16/175) | Up to 12 | AD | Any use | Medication inspection | 8% |
| Cramer (2008)9 | DSM-IV NINCDS-ADRDA MCIc |
Prospective cohort | 70.4 (6.0) 42 |
1674 (Dementia, SU/NSU: 28/102; MCI, 130) |
5 | Dementia; MCI |
Any use | Medication inspection | 31% |
| Sparks (2008)16 | ICD-9 NINCDS-ADRDA |
Clinical trial cohort | 74.8 (3.8) 46 |
2068 (SU/NSU: 4/20; MCI, n/a) | 4 | AD; MCI | Continuous use at all visits | Self-reported | 12% |
| Li (2007)50 | DSM-IV NINCDS-ADRDA |
Prospective cohort | 74.1 (3.8) 67.2 |
110 (12) | n/a | AD | Any use (3 consecutive) | Pharmacy records | n/a |
| Szwast (2007)49 | DSM-III-R ICD-10 |
Prospective cohort | 77.3 (5.3) 38.1 |
1141 (SU/NSU: 3/29) | 3 | Dementia | Use at baseline | Medication inspection | 28% |
| Wolozin (2007)48 | ICD-9 | Prospective cohort | 75 94 |
1290071 (SU/NSU: 3361/3359) | 3 | Dementia | Continuous use in first 7 months | EMRi | n/a |
| Zigman (2007)46 | n/a | Prospective cohort | 41 to 78 22.8 |
123 (SU/NSU: 8/30) | 5.5 | Dementia | Any use | Medication inspection | n/a |
| Rea (2005)22 | NINCDS-ADRDA | Prospective cohort | 75 40 |
2798 (Dementia, SU/NSU: 38/438; AD, SU/NSU: 21/216; VaD, SU/NSU: 7/55) |
5 | Dementia; AD; VaD |
Any use | Medication inspection | n/a |
| Zandi (2005)25 | DSM-III-R NINCDS-ADRDA |
Cross-sectional and prospective cohort | 75.5 (7.1) 42.8 |
3308 (Dementia, SU/NSU: 8/174; AD, SU/NSU: 4/98) |
3 | Dementia; AD | Any use | Medication inspection | 27% |
| Li (2004)21 | DSM-IV NINCDS-ADRDA |
Prospective cohort | 75.1 (6.1) 40.2 |
2356 (Dementia, SU/NSU: 41/271; AD, 168) | 6 | Dementia; AD | Any use (2 consecutive within 6 months) | Pharmacy records | 9% |
| Reitz (2004)23 | NINCDS-ADRDA | Cross-sectional and prospective cohort | 78.4 (6.2) 31.7 |
2126 (AD, 119; VaD, 54) | 4.8 ± 2.9 | AD; VaD | Any use | Medication inspection | 45.1% |
| Yaffe (2002)47 | MCId | Clinical trial cohort | <80 0 |
2126 (SU/NSU: 37/42) | 4 | MCI | Current use | Medication inspection | n/a |
aDefined as decline in Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) word list.
bDefined by Trails-A and B, HVLT-immediate and delayed recall.
cDefined as decline in 3MS, SEVLT.
dDefined by level of 3 MS examination.
Note: the datasets included in this meta-analysis were extracted from the peer-reviewed articles which are not available from open access sources.
Name of the EMR of each study: eMedicare Advantage Prescription Drug plan [MAPD] in Texas; fNational Health Insurance Research Database in Taiwan; gEgton Medical Information System [EMIS] in England and Wales; hHospital Discharge Registry and Drug Reimbursement Registry in Finland; iUS Veterans Affairs database.
Abbreviation: Abbreviations: 3MS: Modified mini-mental state examination; AD = Alzheimer’s Disease; ApoE = Apolipoprotein E; BMI = Body Mass Index; CABG = Coronary artery bypass graft; CAD = Cardiovascular disease; CASI = Cognitive ability screening instrument; CCI = Charlson comorbidity index; CHD = Coronary Heart Disease; DM = Diabetes; EMR = Electronic Medical Records; HTN = Hypertension; HVLT = Hopkins Verbal Learning Test; LDL-C = Low-density lipoprotein cholesterol; LLA = Lipid lowering agents; MCI = Mild cognitive impairment; MR = Mental retardation; N/A = Not Applicable; NSU: No Statin Use; OHA = Oral hypoglycemic agents; SEVLT: Spanish and English Verbal Learning Test; SSRI = Selective serotonin reuptake inhibitor; SU: Statin User; TCA = tricylic antidepressants.