Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults.
Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults.
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他汀类药物治疗对老年人认知能力下降和事件痴呆的影响。
DOI：
10.1016/j.jacc.2021.04.075
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发表时间：
2021-06-29
影响因子：
24
通讯作者：
ASPREE Investigator Group
中科院分区：
文献类型：
--
作者：
Zhou Z;Ryan J;Ernst ME;Zoungas S;Tonkin AM;Woods RL;McNeil JJ;Reid CM;Curtis AJ;Wolfe R;Wrigglesworth J;Shah RC;Storey E;Murray A;Orchard SG;Nelson MR;ASPREE Investigator Group
BackgroundThe neurocognitive effect of statin in older adults remain unknown. ObjectiveThe aim of this study is to investigate the association of statin use with cognitive decline and incidence dementia among older adults.MethodsThis analysis includes 18，846 participants ≥65 years in a randomized trial of aspirin，who have no prior cardiovascular events，major physical disability，或痴呆，并随访了4.7年。结果测量包括偶发性痴呆及其子分类（可能的阿尔茨海默病，混合表现）;轻度认知障碍（MCI）及其子分类（与阿尔茨海默病一致的MCI，其他MCI）;和特定领域认知的变化，包括整体认知，记忆，语言和执行功能，精神速度，以及这些领域的复合。使用考克斯比例风险模型检查基线他汀类药物使用与不使用与痴呆和MCI结局的关系，使用线性混合效应模型检查基线他汀类药物使用与不使用与认知变化的关系，调整潜在混杂因素。他汀类药物的亲脂性对这些协会的影响进行了进一步研究，和效果modifiers identified.ResultsStatin的使用与不使用与痴呆，MCI，或其子分类或随着时间的推移与认知功能评分的变化（P > 0.05）。亲水性和亲脂性他汀类药物使用者之间的任何结局均无差异。基线神经认知能力是他汀类药物与痴呆（p < 0.001）和记忆改变（p = 0.02）相关性的效应修饰因子。结论在≥65岁的成人中，他汀类药物治疗与痴呆、MCI或个体认知领域下降无关。这些发现有待于正在进行的随机试验的证实。
BackgroundThe neurocognitive effect of statins in older adults remain uncertain.ObjectivesThe aim of this study was to investigate the associations of statin use with cognitive decline and incident dementia among older adults.MethodsThis analysis included 18,846 participants ≥65 years of age in a randomized trial of aspirin, who had no prior cardiovascular events, major physical disability, or dementia initially and were followed for 4.7 years. Outcome measures included incident dementia and its subclassifications (probable Alzheimer’s disease, mixed presentations); mild cognitive impairment (MCI) and its subclassifications (MCI consistent with Alzheimer’s disease, other MCI); and changes in domain-specific cognition, including global cognition, memory, language and executive function, psychomotor speed, and the composite of these domains. Associations of baseline statin use versus nonuse with dementia and MCI outcomes were examined using Cox proportional hazards models and with cognitive change using linear mixed-effects models, adjusting for potential confounders. The impact of statin lipophilicity on these associations was further examined, and effect modifiers were identified.ResultsStatin use versus nonuse was not associated with dementia, MCI, or their subclassifications or with changes in cognitive function scores over time (p > 0.05 for all). No differences were found in any outcomes between hydrophilic and lipophilic statin users. Baseline neurocognitive ability was an effect modifier for the associations of statins with dementia (p for interaction < 0.001) and memory change (p for interaction = 0.02).ConclusionsIn adults ≥65 years of age, statin therapy was not associated with incident dementia, MCI, or declines in individual cognition domains. These findings await confirmation from ongoing randomized trials.
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DOI：
10.1056/nejmoa1805819
发表时间：
2018-10-18
期刊：
The New England journal of medicine
影响因子：
--
作者：
McNeil JJ;Wolfe R;Woods RL;Tonkin AM;Donnan GA;Nelson MR;Reid CM;Lockery JE;Kirpach B;Storey E;Shah RC;Williamson JD;Margolis KL;Ernst ME;Abhayaratna WP;Stocks N;Fitzgerald SM;Orchard SG;Trevaks RE;Beilin LJ;Johnston CI;Ryan J;Radziszewska B;Jelinek M;Malik M;Eaton CB;Brauer D;Cloud G;Wood EM;Mahady SE;Satterfield S;Grimm R;Murray AM;ASPREE Investigator Group
通讯作者：
ASPREE Investigator Group
影响因子：
4.6
作者：
Alsehli, Ahmed M.;Olivo, Gaia;Schioth, Helgi B.
通讯作者：
Schioth, Helgi B.
DOI：
10.1016/j.jalz.2011.03.004
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Jack CR Jr;Albert MS;Knopman DS;McKhann GM;Sperling RA;Carrillo MC;Thies B;Phelps CH
通讯作者：
Phelps CH
影响因子：
39.2
作者：
Odden MC;Pletcher MJ;Coxson PG;Thekkethala D;Guzman D;Heller D;Goldman L;Bibbins-Domingo K
通讯作者：
Bibbins-Domingo K
影响因子：
11
作者：
Haag, M. D. M.;Hofman, A.;Breteler, M. M. B.
通讯作者：
Breteler, M. M. B.