The impact of the use of statins on the prevalence of dementia and the progression of cognitive impairment
The impact of the use of statins on the prevalence of dementia and the progression of cognitive impairment
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DOI：
10.1093/gerona/57.7.m414
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发表时间：
2002-07-01
影响因子：
5.1
通讯作者：
Eleazer, GP
中科院分区：
文献类型：
--
作者：
Hajjar, L;Schumpert, J;Eleazer, GP
背景资料。先前的证据表明，用3-羟基-3-甲基戊二酰辅酶-A还原酶抑制剂(他汀类)治疗痴呆症有积极的效果。我们决定调查他汀类药物的使用与痴呆症患病率之间的关系，以及他汀类药物对认知障碍进展的影响。这是一项以社区为基础的初级保健老年实践的病例对照和回顾性队列研究。我们纳入了一个方便的样本，包括所有患有高胆固醇血症或痴呆或服用他汀类药物的患者(N=655，平均年龄78.7±0.3岁，85%高加索人，74%女性)。我们比较了使用他汀类药物的患者和不使用他汀类药物的患者在痴呆症及其亚型的临床诊断和认知障碍的进展方面的差异。在最初的访问中，35%的人患有痴呆症，17%的人使用他汀类药物。经过协变量调整后，服用他汀类药物的患者患痴呆症的可能性较低(根据综合定义，痴呆症的优势比[OR]=0.23；95%可信区间[CI][0.1-0.56]，p=.001；或阿尔茨海默病=0.37+/-95%CI[0.19-0.74]p=.005或血管性痴呆=0.25：95%CI[0.08-0.85]，p=.027)。在后续行动中。服用他汀类药物的患者的Mini-Intelligence Status检查分数提高了0.7+/-0.4，而对照组下降了0.5+/-0.3，p=.025(他汀类药物没有变化或改善的OR=2.81：95%CI[1.02-8.43]，p=.045)，在钟表绘制测试中得分更高(相差1.5+/-0.1，p=.036)。他汀类药物的使用与较低的痴呆症患病率相关，并对认知障碍的进展有积极影响。
Background. Previous evidence suggests that treatment with 3-hydroxy-3-methylgluaryl-coenzyme-A reductase inhibitors (statins) has a positive impact on dementia. We decided to investigate the association between the use of statins and the prevalence of dementia and statins' impact on the progression of cognitive impairment.Methods. This is a case-control and a retrospective cohort study of a community-based ambulatory primary care geriatric practice. We included a convenience sample of all patients (N = 655, mean age 78.7 +/- 0.3 years, 85% Caucasian, 74% women) with hypercholesterolemia or dementia, or using statins. We compared those using statins with those who do not with respect to the clinical diagnosis of dementia and its subtypes and the progression of cognitive impairment.Results. At the initial visit, 35% had dementia, and 17% were using statins. After covariate adjustments, patients on statins were less likely to have dementia (odds ratio [OR] for dementia based on composite definition = 0.23; 95% confidence interval [CI] [0.1-0.56], p = .001, OR Alzheimer's disease = 0.37 +/- 95% CI [0.19-0.74] p = .005 OR vascular dementia = 0.25: 95% CI [0.08-0.85], p = .027). At follow-up. patients on statins showed an improvement on their Mini-Mental Status Examination score by 0.7 +/- 0.4 compared to a decline by 0.5 +/- 0.3 in controls, p = .025 (OR for no change or improvement on statins = 2.81: 95% CI [1.02-8.43], p = .045) and scored higher on the Clock Drawing Test (difference of 1.5 +/- 0.1, p = .036).Conclusions. The use of statins is associated with a lower prevalence of dementia and has a positive impact on the progression of cognitive impairment.