Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment

May A. Beydoun, Lori L. Beason-Held, Melissa H. Kitner-Triolo, Hind A. Beydoun, Luigi Ferrucci, Susan M. Resnick, Alan B. Zonderman

Research output: Contribution to journalArticle

Abstract

Background: Statin use and serum cholesterol reduction have been proposed as preventions for dementia and mild cognitive impairment (MCI). Methods: 1604 and 1345 eligible participants from the Baltimore Longitudinal Study of Aging (BLSA) were followed after age 50 for a median time of around 25 years, to examine the incidence of dementia (n=259) and MCI (n=138), respectively. Statin use (ever-use and time-dependent use), total cholesterol levels (TC; first visit and time-dependent), TC change trajectory from first visit and high-density lipoprotein (HDL-C):TC ratio (first visit and time-dependent) were the main exposures of interest. Cox proportional hazards models were used. Results: Participants with incident dementia had a higher first-visit TC compared with participants who remained free of dementia and MCI, while first-visit TC was higher among statin ever-users compared with never-users (age-unadjusted associations). Statin users had a twoto threefold lower risk of developing dementia (HR=0.41; 95% CI 0.18 to 0.92), but not MCI, when considering time-dependent 'statin use' with propensity score model adjustment. This association remained significant independently of serum cholesterol exposures. An elevated first-visit TC was associated with reduced MCI risk (upper quartile (Q4) vs Q1: HR=0.51; 95% CI 0.29 to 0.90). Compared with the lowest quartile (Q1: 0.00e0.19), HDL-C:TC (time-dependent) in (Q2: 0.19e0.24) was associated with reduced MCI risk (HR=0.58; 95% CI 0.34 to 0.98). Among men only, TC decline from first visit was significantly associated with increased dementia risk (HR=4.21; 95% CI 1.28 to 13.85). Conclusions: Statins may have multifactorial effects on dementia but not MCI risk. Future interventions may be warranted, and research should focus on optimal serum TC, HDL-C:TC ratio and TC change trajectories.

Original languageEnglish (US)
Pages (from-to)949-957
Number of pages9
JournalJournal of Epidemiology and Community Health
Volume65
Issue number11
DOIs
StatePublished - Nov 2011
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Dementia
Cholesterol
Serum
Social Adjustment
Propensity Score
Baltimore
HDL Lipoproteins
Cognitive Dysfunction
Proportional Hazards Models
Longitudinal Studies
Incidence
Research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

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Beydoun, M. A., Beason-Held, L. L., Kitner-Triolo, M. H., Beydoun, H. A., Ferrucci, L., Resnick, S. M., & Zonderman, A. B. (2011). Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment. Journal of Epidemiology and Community Health, 65(11), 949-957. https://doi.org/10.1136/jech.2009.100826

Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment. / Beydoun, May A.; Beason-Held, Lori L.; Kitner-Triolo, Melissa H.; Beydoun, Hind A.; Ferrucci, Luigi; Resnick, Susan M.; Zonderman, Alan B.

In: Journal of Epidemiology and Community Health, Vol. 65, No. 11, 11.2011, p. 949-957.

Research output: Contribution to journalArticle

Beydoun, MA, Beason-Held, LL, Kitner-Triolo, MH, Beydoun, HA, Ferrucci, L, Resnick, SM & Zonderman, AB 2011, 'Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment', Journal of Epidemiology and Community Health, vol. 65, no. 11, pp. 949-957. https://doi.org/10.1136/jech.2009.100826
Beydoun, May A. ; Beason-Held, Lori L. ; Kitner-Triolo, Melissa H. ; Beydoun, Hind A. ; Ferrucci, Luigi ; Resnick, Susan M. ; Zonderman, Alan B. / Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment. In: Journal of Epidemiology and Community Health. 2011 ; Vol. 65, No. 11. pp. 949-957.
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abstract = "Background: Statin use and serum cholesterol reduction have been proposed as preventions for dementia and mild cognitive impairment (MCI). Methods: 1604 and 1345 eligible participants from the Baltimore Longitudinal Study of Aging (BLSA) were followed after age 50 for a median time of around 25 years, to examine the incidence of dementia (n=259) and MCI (n=138), respectively. Statin use (ever-use and time-dependent use), total cholesterol levels (TC; first visit and time-dependent), TC change trajectory from first visit and high-density lipoprotein (HDL-C):TC ratio (first visit and time-dependent) were the main exposures of interest. Cox proportional hazards models were used. Results: Participants with incident dementia had a higher first-visit TC compared with participants who remained free of dementia and MCI, while first-visit TC was higher among statin ever-users compared with never-users (age-unadjusted associations). Statin users had a twoto threefold lower risk of developing dementia (HR=0.41; 95{\%} CI 0.18 to 0.92), but not MCI, when considering time-dependent 'statin use' with propensity score model adjustment. This association remained significant independently of serum cholesterol exposures. An elevated first-visit TC was associated with reduced MCI risk (upper quartile (Q4) vs Q1: HR=0.51; 95{\%} CI 0.29 to 0.90). Compared with the lowest quartile (Q1: 0.00e0.19), HDL-C:TC (time-dependent) in (Q2: 0.19e0.24) was associated with reduced MCI risk (HR=0.58; 95{\%} CI 0.34 to 0.98). Among men only, TC decline from first visit was significantly associated with increased dementia risk (HR=4.21; 95{\%} CI 1.28 to 13.85). Conclusions: Statins may have multifactorial effects on dementia but not MCI risk. Future interventions may be warranted, and research should focus on optimal serum TC, HDL-C:TC ratio and TC change trajectories.",
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T1 - Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment

AU - Beydoun, May A.

AU - Beason-Held, Lori L.

AU - Kitner-Triolo, Melissa H.

AU - Beydoun, Hind A.

AU - Ferrucci, Luigi

AU - Resnick, Susan M.

AU - Zonderman, Alan B.

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Y1 - 2011/11

N2 - Background: Statin use and serum cholesterol reduction have been proposed as preventions for dementia and mild cognitive impairment (MCI). Methods: 1604 and 1345 eligible participants from the Baltimore Longitudinal Study of Aging (BLSA) were followed after age 50 for a median time of around 25 years, to examine the incidence of dementia (n=259) and MCI (n=138), respectively. Statin use (ever-use and time-dependent use), total cholesterol levels (TC; first visit and time-dependent), TC change trajectory from first visit and high-density lipoprotein (HDL-C):TC ratio (first visit and time-dependent) were the main exposures of interest. Cox proportional hazards models were used. Results: Participants with incident dementia had a higher first-visit TC compared with participants who remained free of dementia and MCI, while first-visit TC was higher among statin ever-users compared with never-users (age-unadjusted associations). Statin users had a twoto threefold lower risk of developing dementia (HR=0.41; 95% CI 0.18 to 0.92), but not MCI, when considering time-dependent 'statin use' with propensity score model adjustment. This association remained significant independently of serum cholesterol exposures. An elevated first-visit TC was associated with reduced MCI risk (upper quartile (Q4) vs Q1: HR=0.51; 95% CI 0.29 to 0.90). Compared with the lowest quartile (Q1: 0.00e0.19), HDL-C:TC (time-dependent) in (Q2: 0.19e0.24) was associated with reduced MCI risk (HR=0.58; 95% CI 0.34 to 0.98). Among men only, TC decline from first visit was significantly associated with increased dementia risk (HR=4.21; 95% CI 1.28 to 13.85). Conclusions: Statins may have multifactorial effects on dementia but not MCI risk. Future interventions may be warranted, and research should focus on optimal serum TC, HDL-C:TC ratio and TC change trajectories.

AB - Background: Statin use and serum cholesterol reduction have been proposed as preventions for dementia and mild cognitive impairment (MCI). Methods: 1604 and 1345 eligible participants from the Baltimore Longitudinal Study of Aging (BLSA) were followed after age 50 for a median time of around 25 years, to examine the incidence of dementia (n=259) and MCI (n=138), respectively. Statin use (ever-use and time-dependent use), total cholesterol levels (TC; first visit and time-dependent), TC change trajectory from first visit and high-density lipoprotein (HDL-C):TC ratio (first visit and time-dependent) were the main exposures of interest. Cox proportional hazards models were used. Results: Participants with incident dementia had a higher first-visit TC compared with participants who remained free of dementia and MCI, while first-visit TC was higher among statin ever-users compared with never-users (age-unadjusted associations). Statin users had a twoto threefold lower risk of developing dementia (HR=0.41; 95% CI 0.18 to 0.92), but not MCI, when considering time-dependent 'statin use' with propensity score model adjustment. This association remained significant independently of serum cholesterol exposures. An elevated first-visit TC was associated with reduced MCI risk (upper quartile (Q4) vs Q1: HR=0.51; 95% CI 0.29 to 0.90). Compared with the lowest quartile (Q1: 0.00e0.19), HDL-C:TC (time-dependent) in (Q2: 0.19e0.24) was associated with reduced MCI risk (HR=0.58; 95% CI 0.34 to 0.98). Among men only, TC decline from first visit was significantly associated with increased dementia risk (HR=4.21; 95% CI 1.28 to 13.85). Conclusions: Statins may have multifactorial effects on dementia but not MCI risk. Future interventions may be warranted, and research should focus on optimal serum TC, HDL-C:TC ratio and TC change trajectories.

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