Statins Didn't Alter the Mind

Statins appeared not to negatively impact cognition

(RxWiki News) There has been some uncertainty about statins potentially causing mental confusion and impairment. Researchers have looked at the relationship again.

Statins (cholesterol lowering medications) did not lower cognitive function, and may in fact decrease the risks of dementia, according to a new analysis of previously published studies.

The authors of this review concluded that larger, well-designed studies are needed to delve into the relationship between statins — particularly high-dose statins — and cognition.

"Talk to your pharmacist about the side effects of all your medications."

This meta-analysis was conducted by Karl Richardson, MD, of the Perelman Center for Advanced Medicine in Philadelphia, PA, and colleagues. These researchers analyzed published research addressing statins and cognition (brain-related skills like thinking, language, memory, etc.)

Statins are among the most widely prescribed medications in the US. They are sold under various brand names, including Crestor (rosuvastatin), Lipitor (Atorvastatin) and Zocor (simvastatin).

In 2012, the US Food and Drug Administration (FDA) made label changes to statins, warning of cognitive decline as possible side effects.

The FDA specifically stated that “ill-defined memory loss” and “confusion” were among the cognitive effects noted in statin users.

In this meta-analysis, Dr. Richardson and team evaluated the findings of 25 studies that measured cognitive status among statin users. These scientists labeled the quality of the research as low- or moderate-quality evidence.

They found that moderate-quality evidence suggested statin use did not increase the incidence of mild cognitive decline or dementia, a condition that changes brain function and results in memory loss and impaired thinking/reasoning skills.

Dr. Richardson and colleagues reported that an examination of 10 previously published studies involving 4,360,137 individuals found that statins were associated with a 13 percent decreased risk for dementia compared to not taking statins.

Another pooled analysis of studies involving 759,553 people concluded that statin users had a 21 percent lower risk for Alzheimer’s disease than people not taking these medications.

Dr. Richardson and colleagues also reviewed FDA surveillance databases and found 1.9 reports of cognitive-related side effects for every million prescriptions. This was similar to the reporting of cognitive adverse events for other heart medications — Plavix (clopidogrel) had 1.9 reported cases of cognitive adverse events per million prescriptions, and Cozaar and Hyzaar (losartan) had 1.6 cases per million prescriptions.

Based on these findings, the researchers of this meta-analysis concluded, “Published data do not suggest an adverse effect of statins on cognition; however, the strength of available evidence is limited, particularly with regard to high-dose statins.”

A similar meta-analysis was published in the Mayo Clinic Proceedings. The authors of that study concluded, “In patients without baseline cognitive dysfunction, short-term data are most compatible with no adverse effect of statins on cognition, and long-term data may support a beneficial role for statins in the prevention of dementia.”

Dr. Richardson’s study was published November 18 in the Annals of Internal Medicine.

No conflicts of interest were declared.

Review Date: 
November 29, 2013