Table 3.
Studies investigating the associations between statin use and Alzheimer disease (AD).
| References | Study design | Subject number (mean age) | F/U duration | Assessment | Diagnosis | Statin Name and Dosage | Main findings |
|---|---|---|---|---|---|---|---|
| EPIDEMIOLOGICAL STUDY | |||||||
| Zandi et al. (116) | Prospective | 4,895 (statin = 73 ± 5 yrs, nonuser = 76 ± 7 yrs) | 3 years | DSM-III-R | AD | Any use | No association with subsequent onset of AD; aHR(95% CI) = 1.19 (0.35–2.96) |
| Sparks et al. (117) | Prospective | 2,528 (75 ± 4 yrs) | 5 years | DSM-IV NINCDS-ADRDA |
AD | Any use | Reduced risk of AD; aHR(95% CI) = 0.33 (0.11–0.98) |
| Li et al. (118) | Prospective | 3,099 (statin = 74 ± 6, non-user = 76 ± 6 yrs) | 6 years | NINCDS-ADRDA, DSM-IV |
AD | Any use | Reduced risk of AD; aHR(95% CI) = 0.62 (0.40–0.97) Strength of the statin diminished with age |
| Zissimopoulos et al. (119) | Retrospective | 399,979 (women 76 and men 75 yrs) | 5 years | ICD-9 | AD | atorvastatin, pravastatin, rosuvastatin |
Reduced risk of AD diagnosis for women: aHR(95% CI) = 0.85 (0.82–0.89) for men: aHR(95% CI) = 0.88 (0.83–0.93) |
| Zamrini et al. (120) | Case control | 505 AD-paired patients (73 yrs) | ICD-9 | AD | Any use | Reduced risk of AD; aOR (95% CI) = 0.61 (0.42–0.87) | |
| INTERVENTIONAL STUDY | |||||||
| Simons et al. (121) | RCT | 44 statin and 68 placebo (68 ± 8 yrs) | 26 weeks | NINCDS-ADRDA | mild-to-moderate AD | Simvastatin 80 mg |
A small but significant reduction of Abeta40 in the CSF of mild but not moderate AD patients. |
| Sparks et al. (122) | RCT | 32 statin and 31 placebo (78 ± 1 yrs) | 1 year | DSM-IV NINCDS-ADRDA |
mild-to-moderate AD | Atorvastatin 80 mg |
Atorvastatin may slow the progression of mild to-moderate AD |
| Feldman et al. (123) | RCT | 297 statin and 317 placebo (74 ± 8 yrs) | 72 weeks | ADAS-Cog | mild-to-moderate AD | Atorvastatin 80 mg |
No significant clinical benefit |
| Sano et al. (124) | RCT | 204 statin and 202 placebo (75 ± 9 yrs) | 18 months | ADAS-Cog | mild-to-moderate AD | Simvastatin 40 mg |
No benefit on the progression of symptoms despite significant lowering of cholesterol. |
| Lin et al. (125) | Case control | 719 AD-paired patients | ≥1 year | ICD-9 DSM-IV |
mild-to-moderate AD | Any use | Early stain use exhibited a 0.85-risk (95% CI = 0.76–0.95) to have AD progression than those without. |
Yrs, years; RCT, randomized controlled trial; DSM, Diagnostic and Statistical Manual of Mental Disorders; aHR, Adusted Hazard Ratio; NINCDS-ADRDA, National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association; ADAS-Cog, Alzheimer's Disease Assessment Scale-Cognitive Subscale test; ICD-9, International Classification of Diseases, Ninth Revision.