Statins Do Not Cause Memory Loss
Current evidence does not support that statins cause memory loss or cognitive impairment. Multiple high-quality guidelines and randomized controlled trials have found no significant association between statin use and cognitive decline 1.
Evidence Against Statin-Induced Memory Loss
The most recent systematic review of the FDA's post-marketing surveillance databases, randomized controlled trials, and cohort, case-control, and cross-sectional studies found that published data do not reveal an adverse effect of statins on cognition 1.
Three large randomized trials of statin versus placebo specifically performed cognitive tests, and no differences were seen between statin and placebo groups 1.
The 2018 European Atherosclerosis Society Consensus Panel statement concluded that several lines of evidence point against an association between statins and cognitive dysfunction 1.
No change in cognitive function has been reported in studies with the addition of ezetimibe or PCSK9 inhibitors to statin therapy, even among patients treated to very low LDL cholesterol levels 1.
The U.S. Preventive Services Task Force (USPSTF) found no clear evidence of decreased cognitive function associated with statin use 1.
FDA Drug Label Information
- While the FDA drug labels for statins like atorvastatin and simvastatin mention rare reports of cognitive impairment (memory loss, forgetfulness, amnesia, confusion), they note that these effects are generally:
Conflicting Evidence
Some case reports and observational studies have suggested potential cognitive effects, but these are not supported by randomized controlled trials 4, 5.
A 2024 pharmacovigilance analysis using FDA's Adverse Event Reporting System suggested memory loss may be associated with atorvastatin use 6, but this conflicts with multiple randomized controlled trials that found no such association.
Case reports of statin-associated memory loss exist in the literature, including for simvastatin, atorvastatin, and rosuvastatin 4, 7, but causality cannot be established from these reports.
Clinical Implications
The American Diabetes Association guidelines explicitly state that "a concern that statins or other lipid-lowering agents might cause cognitive dysfunction or dementia is not currently supported by evidence and should not deter their use in individuals at high risk for ASCVD" 1.
The benefits of statins for cardiovascular risk reduction far outweigh any potential cognitive risks, especially in high-risk populations 1.
The American College of Cardiology/American Heart Association Task Force on Practice Guidelines found no evidence that statins had an adverse effect on cognitive changes or risk of dementia 1.
The Diabetes Care guidelines specifically state that fear of cognitive decline should not be a barrier to statin use in individuals with diabetes and high cardiovascular risk 1.
Monitoring and Management
While routine cognitive monitoring is not recommended for patients on statins, clinicians should be aware of patient reports of cognitive symptoms 1, 2.
If cognitive symptoms occur while on statin therapy, consider:
The risk-benefit assessment should always prioritize cardiovascular risk reduction, as the evidence for cardiovascular benefit is robust, while evidence for cognitive harm is weak 1.