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Are statins associated with cognitive impairment or dementia? Review scope Included studies compared statin therapy with control in adults and evaluated cognitive function, including cognitive impairment, Alzheimer disease, and dementia. Review methods MEDLINE, EMBASE/Excerpta Medica, and Cochrane Library (all to Oct 2012) were searched for randomized controlled trials (RCTs), cohort studies, case–control studies, and cross-sectional studies published in English. Reference lists were searched. 57 studies met the selection criteria; 27 studies (3 RCTs, 16 cohort studies, 4 case–control studies, and 4 cross-sectional studies) were included in quantitative analyses. Main results Meta-analyses showed that statin exposure was not associated with increased risk for incident dementia, Alzheimer disease, or mild cognitive impairment (Table). 1 RCT (n = 5804) found no difference between statins and placebo for change in global cog-nitive performance (Mini-Mental State Examination) in patients who were cognitively intact at baseline (0.06, CI −0.04 to 0.16). Pooled-analysis of 3 RCTs (n = 1064) found that statin- and placebo-treated patients with cognitive impairment at baseline did not differ for change in cognitive performance (difference in score on Alzheimer disease Assessment Score–Cognitive Portion 0.11, 95 % CI −1.76 to 1.97). Conclusion Statins are not associated with increased risk for dementia, Alzheimer disease, or mild cognitive impairment in adults with no cognitive dysfunction; they do not affect cognitive performance in adults with or without cognitive impairment