451 Statins ineffective for dementia

February 13, 2015

written by Brian R McAvoy

Clinical question
How effective are statins in the treatment of dementia?

Bottom line
Compared with placebo, there was no benefit from statins seen with the primary outcome measure, Alzheimer's Disease Assessment Scale – cognitive subscale (ADAS-Cog) or the Mini Mental State Examination. There was no significant difference in behaviour, global function or activities of daily living in the statin and placebo groups. All participants had a diagnosis of probable or possible Alzheimer’s disease (AD) according to standard criteria and most participants were established on cholinesterase inhibitors. Participants’ ages ranged from 50 to 90 years, and treatment was given for at least 6 months. There were no significant differences in adverse effects between treatment and placebo groups

Caveat
The review contained only 4 studies, involving 1154 participants. There were no studies assessing the role of statins in the treatment of vascular dementia.

Context
The use of statin therapy in established AD or vascular dementia is a relatively unexplored area. Hypercholesterolaemia has also been implicated in the pathogenesis of vascular dementia. Owing to the role of statins in cholesterol reduction, it is biologically plausible they may be efficacious.

Cochrane Systematic Review
McGuinness B et al. Statins for the treatment of dementia. Cochrane Reviews. 2014, Issue 7. Art. No.: CD007514.DOI: 10.1002/14651858. CD007514.pub3. This review contains 4 studies involving 1154 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.