Use of blood fat-lowering statins linked to slower progression of Alzheimer's dementia

Blood fat-lowering statins could slow the progression of Alzheimer's disease, at least for some patients. This is the result of a new study led by Karolinska Institutet published in Alzheimer Research and Therapy. But the researchers are cautious in their interpretations and see the results as a first step in a research journey that may eventually provide the answer.

A new study shows that people with Alzheimer's dementia deteriorated more slowly in their cognitive functions if they were also treated with a lipid-lowering statin, compared to those who were not treated. However, the study is an observational study where the researchers have compared data on the patients from a registry and therefore cannot answer whether there really is a causal relationship. Thus, the researchers are cautious in their interpretations.

People with Alzheimer's dementia treated with statins had better cognitive development over time. However, the results of the study do not mean that we now have evidence that people with dementia should be treated with statins. But on the other hand, we can't see any support for not doing so. So, if a person needs statins for high blood lipids, a dementia diagnosis should not stop the treatment."

Sara Garcia-Ptacek, Associate Professor of Neuroscience and Associate Senior Lecturer at the Department of Neurobiology, Care Sciences and Society, and research leader of the current study

The reason she emphasizes safety is that statins were initially suspected of causing confusion in patients with dementia. There has therefore been some resistance to prescribing statins to these patients.

The study included data from more than 15 500 patients with dementia who also had an indication for lipid-lowering treatment. Almost 11 000 of them were treated with statins. In general, the patients who were treated with statins had slightly higher values in the cognitive tests carried out, even though they were more likely to have diagnoses such as high blood pressure, cardiovascular disease and diabetes, all of which are risk factors for dementia.

Sara Garcia-Ptacek explains that the research team started with a hypothesis that statins could slow the progression of dementia and cast a fairly wide net to see if they could find evidence of this.

"The basic idea of this study was to pave the way for a more precise cohort study that could eventually lead to a clinical intervention study, which is what is needed to prove a causal link between statins and cognition," says Sara Garcia-Ptacek.

The idea that statins could affect the risk or progression of dementia is not new. There are even some clinical studies done, but they have all been negative.

"We believe that only certain patients with Alzheimer's dementia may benefit from statins and that previous clinical trials have been too small to show any significant differences. "Our idea is to try to crystallize which patient groups benefit the most and why, before embarking on clinical trials," says Sara Garcia-Ptacek.

The research was funded by Region Stockholm, the Swedish Research Council and the Dementia and Margareta af Ugglas Foundation.

Source:
Journal reference:

Petek, B., et al. (2023) Statins and cognitive decline in patients with Alzheimer’s and mixed dementia: a longitudinal registry-based cohort study. Alzheimer's Research & Therapy. doi.org/10.1186/s13195-023-01360-0.

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