Het verband tussen statinegebruik en cognitieve functie, een cross-sectionele analyse van het PREVEND cohort

Introduction: Dementia is a common disorder among the elderly. Cardiovascular and cholesterol related mechanisms might play a role in the pathogenesis of Alzheimer’s disease (AD) and vascular dementia. Therefore statins could possibly prevent dementia due to their cholesterol lowering and pleiotropic effects. Cross-sectional studies suggest a lower prevalence of AD among statin users. Longitudinal studies provided inconsistent reports. RCTs provided evidence that statins given at late life have no effect in preventing AD or dementia. It remains unclear whether statins given at middle age have effect on cognitive function. Aim: To asses whether statins given at middle to old age have effect on a continuous outcome variable for cognitive function. Methods: This study is part of the PREVEND study. PREVEND is a single-centre, prospective observational cohort study among the citizens of Groningen. 4158 participants completed cognitive function testing. We used the Ruff Figural Fluency Test (RFFT) for this purpose. Medication data about statin use was collected from the pharmacy database. For every statin user we matched a control on age and education. Results: There were 915 statin users vs. 910 matched non users. The mean RFFT score (SD) for the complete cohort was 60 (24). The RFFT score was dependent on age and education, but not on sex. Statin users scored significantly worse compared to matched non users: mean RFFT score (SD) 58 (23) vs. 61 (24) (p=0,008). This significant difference disappeared after correction for age, education and cardiovascular risk factors (p=0,37). The negative association between RFFT score and lipophilic statin use, longer statin use and lower statin dose disappeared after correction for age, education and cardiovascular risk factors. Conclusion: In PREVEND statin use was not associated with better cognitive functioning. It is probable that earlier reports of lower prevalence of dementia among statin users was a result of methodological shortcomings.