From the Guidelines
Statins do not have negative effects on brain health.
Evidence Summary
- The use of statins has been extensively studied in relation to cognitive function, and the consensus is that they do not cause cognitive dysfunction or dementia 1.
- Multiple large randomized trials have compared statin use to placebo and found no differences in cognitive test results 1.
- The addition of other lipid-lowering agents, such as ezetimibe or PCSK9 inhibitors, to statin therapy has also not been shown to affect cognitive function 1.
- Systematic reviews of postmarketing surveillance databases, randomized controlled trials, and cohort, case-control, and cross-sectional studies have found no evidence of an adverse effect of statins on cognition 1.
- The U.S. Food and Drug Administration’s postmarketing surveillance databases have reported a low rate of cognitive-related adverse events with statin therapy, similar to rates seen with other commonly prescribed cardiovascular medications 1.
- While some studies have suggested a potential increased risk of diabetes with high-dose statin use, the evidence for cognitive harms is relatively sparse, and further research is needed to establish a definitive relationship between statin use and cognitive function 1.
- However, based on the current evidence, fear of cognitive decline should not be a barrier to statin use in individuals with diabetes and a high risk for cardiovascular disease 1.
From the Research
Statins and Brain Health
- Statins have been found to have both positive and negative effects on brain health, with some studies suggesting they can cause reversible cognitive impairment in some patients, while others indicate they may decrease the risk of dementia and Alzheimer's disease 2, 3.
- The mechanisms behind these effects are thought to be independent of each other, which may explain the contradicting results found in different studies 2.
- Factors such as individual characteristics and statin-related factors can modify the cognitive effects of statins, and understanding these factors is crucial to determining the impact of statins on brain health 3.
Cognitive Impairment and Statins
- Some studies have reported an association between statin use and transient cognitive decline, although randomized controlled trials have not confirmed cognitive impairing effects with statins 2, 4.
- The evidence for both positive and negative effects of statins on cognitive function is compelling, but the limitations of clinical trials may explain the lack of findings 2.
Neuroprotective Effects of Statins
- Statins have been found to have neuroprotective effects in various neurological disorders, including Alzheimer's disease, Parkinson's disease, and stroke, due to their anti-inflammatory, anti-oxidant, and anti-platelet properties 5, 6.
- However, the effectiveness of statins in treating these disorders has not been conclusively proven in vivo or in adequate clinical trials, and more research is needed to determine their pharmacological effectiveness in the brain 5, 6.