Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort study
Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort study
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DOI：
10.1212/01.wnl.0000319647.15752.7b
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发表时间：
2008-07-29
期刊：
影响因子：
9.9
通讯作者：
Kalbfleisch, J. D.
中科院分区：
文献类型：
--
作者：
Cramer, C.;Haan, M. N.;Kalbfleisch, J. D.
目的：降脂药物的使用与认知结果之间的关系的证据是混合的。本研究的目的是测试使用他汀类药物和痴呆症的发病率和认知功能障碍无痴呆症（CIND）超过5年的following.Methods：数据来自一项以人群为基础的队列研究，包括1,789老年墨西哥裔美国人之间的关联。所有参与者每12至15个月进行一次认知和临床评估。然后对认知测试中低于指定临界点的参与者进行临床评估。痴呆症的诊断由一个裁定小组最后确定。共有1，674名基线时无痴呆/CIND的参与者被纳入这些分析。他汀类药物的使用在每个参与者的家中通过药柜检查进行验证。考克斯比例风险模型被用来评估他汀类药物的使用和痴呆/CIND.Results的发病率之间的关联：总体而言，452的1,674名参与者（27%）在研究期间的任何时间服用他汀类药物。在5年的随访期间，130名参与者发展为痴呆/CIND。在校正了受教育程度、吸烟状况、存在至少一个APOE（APOE）4等位基因以及基线时有中风或糖尿病史的考克斯比例风险模型中，使用他汀类药物的患者发生痴呆/CIND的可能性约为未使用他汀类药物的患者的一半结论：在5年随访期间，他汀类药物使用者不太可能发生无痴呆的痴呆/认知障碍。这些结果增加了新出现的证据，表明他汀类药物的使用对认知结果的保护作用。
Objective: Evidence of a relation between use of lipid lowering drugs and cognitive outcomes is mixed. This study aimed to test the association between use of statins and incidence of dementia and cognitive impairment without dementia (CIND) over 5 years of follow-up.Methods: Data were from a population-based cohort study comprising 1,789 older Mexican Americans. All participants had cognitive and clinical evaluations performed every 12 to 15 months. Participants who fell below specified cutpoints on cognitive tests were then evaluated clinically. Dementia diagnoses were finalized by an adjudication team. A total of 1,674 participants free of dementia/CIND at baseline were included in these analyses. Statin use was verified at each participant's home by medicine cabinet inspection. Cox proportional hazards models were used to evaluate the association between statin use and incidence of dementia/CIND.Results: Overall, 452 of 1,674 participants (27%) took statins at any time during the study. Over the 5-year follow-up period, 130 participants developed dementia/CIND. In Cox proportional hazards models adjusted for education, smoking status, presence of at least one APOE (epsilon)4 allele, and history of stroke or diabetes at baseline, persons who had used statins were about half as likely as those who did not use statins to develop dementia/CIND (HR = 0.52; 95% CI 0.34, 0.80).Conclusion: Statin users were less likely to have incident dementia/cognitive impairment without dementia during a 5-year follow-up. These results add to the emerging evidence suggesting a protective effect of statin use on cognitive outcomes.