Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease

BACKGROUND: Statins are a class of medications that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Whether statins can benefit patients with dementia remains unclear because of conflicting results. We hypothesized that some of the confusion in the literature might...

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Autores principales: Wolozin, Benjamin, Wang, Stanley W, Li, Nien-Chen, Lee, Austin, Lee, Todd A, Kazis, Lewis E
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955446/
https://www.ncbi.nlm.nih.gov/pubmed/17640385
http://dx.doi.org/10.1186/1741-7015-5-20
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author Wolozin, Benjamin
Wang, Stanley W
Li, Nien-Chen
Lee, Austin
Lee, Todd A
Kazis, Lewis E
author_facet Wolozin, Benjamin
Wang, Stanley W
Li, Nien-Chen
Lee, Austin
Lee, Todd A
Kazis, Lewis E
author_sort Wolozin, Benjamin
collection PubMed
description BACKGROUND: Statins are a class of medications that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Whether statins can benefit patients with dementia remains unclear because of conflicting results. We hypothesized that some of the confusion in the literature might arise from differences in efficacy of different statins. We used a large database to compare the action of several different statins to investigate whether some statins might be differentially associated with a reduction in the incidence of dementia and Parkinson's disease. METHODS: We analyzed data from the decision support system of the US Veterans Affairs database, which contains diagnostic, medication and demographic information on 4.5 million subjects. The association of lovastatin, simvastatin and atorvastatin with dementia was examined with Cox proportional hazard models for subjects taking statins compared with subjects taking cardiovascular medications other than statins, after adjusting for covariates associated with dementia or Parkinson's disease. RESULTS: We observed that simvastatin is associated with a significant reduction in the incidence of dementia in subjects ≥65 years, using any of three models. The first model incorporated adjustment for age, the second model included adjusted for three known risk factors for dementia, hypertension, cardiovascular disease or diabetes, and the third model incorporated adjustment for the Charlson index, which is an index that provides a broad assessment of chronic disease. Data were obtained for over 700000 subjects taking simvastatin and over 50000 subjects taking atorvastatin who were aged >64 years. Using model 3, the hazard ratio for incident dementia for simvastatin and atorvastatin are 0.46 (CI 0.44–0.48, p < 0.0001) and 0.91 (CI 0.80–1.02, p = 0.11), respectively. Lovastatin was not associated with a reduction in the incidence of dementia. Simvastatin also exhibited a reduced hazard ratio for newly acquired Parkinson's disease (HR 0.51, CI 0.4–0.55, p < 0.0001). CONCLUSION: Simvastatin is associated with a strong reduction in the incidence of dementia and Parkinson's disease, whereas atorvastatin is associated with a modest reduction in incident dementia and Parkinson's disease, which shows only a trend towards significance.
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spelling pubmed-19554462007-08-29 Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease Wolozin, Benjamin Wang, Stanley W Li, Nien-Chen Lee, Austin Lee, Todd A Kazis, Lewis E BMC Med Research Article BACKGROUND: Statins are a class of medications that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Whether statins can benefit patients with dementia remains unclear because of conflicting results. We hypothesized that some of the confusion in the literature might arise from differences in efficacy of different statins. We used a large database to compare the action of several different statins to investigate whether some statins might be differentially associated with a reduction in the incidence of dementia and Parkinson's disease. METHODS: We analyzed data from the decision support system of the US Veterans Affairs database, which contains diagnostic, medication and demographic information on 4.5 million subjects. The association of lovastatin, simvastatin and atorvastatin with dementia was examined with Cox proportional hazard models for subjects taking statins compared with subjects taking cardiovascular medications other than statins, after adjusting for covariates associated with dementia or Parkinson's disease. RESULTS: We observed that simvastatin is associated with a significant reduction in the incidence of dementia in subjects ≥65 years, using any of three models. The first model incorporated adjustment for age, the second model included adjusted for three known risk factors for dementia, hypertension, cardiovascular disease or diabetes, and the third model incorporated adjustment for the Charlson index, which is an index that provides a broad assessment of chronic disease. Data were obtained for over 700000 subjects taking simvastatin and over 50000 subjects taking atorvastatin who were aged >64 years. Using model 3, the hazard ratio for incident dementia for simvastatin and atorvastatin are 0.46 (CI 0.44–0.48, p < 0.0001) and 0.91 (CI 0.80–1.02, p = 0.11), respectively. Lovastatin was not associated with a reduction in the incidence of dementia. Simvastatin also exhibited a reduced hazard ratio for newly acquired Parkinson's disease (HR 0.51, CI 0.4–0.55, p < 0.0001). CONCLUSION: Simvastatin is associated with a strong reduction in the incidence of dementia and Parkinson's disease, whereas atorvastatin is associated with a modest reduction in incident dementia and Parkinson's disease, which shows only a trend towards significance. BioMed Central 2007-07-19 /pmc/articles/PMC1955446/ /pubmed/17640385 http://dx.doi.org/10.1186/1741-7015-5-20 Text en Copyright © 2007 Wolozin et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wolozin, Benjamin
Wang, Stanley W
Li, Nien-Chen
Lee, Austin
Lee, Todd A
Kazis, Lewis E
Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease
title Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease
title_full Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease
title_fullStr Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease
title_full_unstemmed Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease
title_short Simvastatin is associated with a reduced incidence of dementia and Parkinson's disease
title_sort simvastatin is associated with a reduced incidence of dementia and parkinson's disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955446/
https://www.ncbi.nlm.nih.gov/pubmed/17640385
http://dx.doi.org/10.1186/1741-7015-5-20
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