Cochrane cautious on statins for dementia prevention
MedWire News: There is insufficient evidence to recommend use of statins to prevent vascular dementia or dementia related to Alzheimer's Disease (AD), conclude Cochrane reviewers.
However, the team notes that this therapeutic area is relatively unexplored, and says the picture may become clearer with the publication of CLASP (Cholesterol Lowering Agent to Slow Progression of AD).
Bernadette McGuinness (Queen's University Belfast, UK) and colleagues did not find any studies of statins in patients with or at risk for vascular dementia that met their inclusion criteria.
Three studies in AD patients met the inclusion criteria. These involved 748 patients aged 50-90 years. Patients in these studies were randomly assigned to receive atorvastatin, simvastatin, or placebo.
The studies lasted for up to 18 months, during which time patients on active treatment experienced the expected falls in low-density lipoprotein cholesterol levels.
However, there was no significant difference in changes on the AD Assessment Scale Cognitive Subscale between active and placebo treatment, at a pooled nonsignificant 1.12-point difference in favor of statin treatment.
There was no significant difference in change in Mini Mental State Examination (MMSE) score, with statin-treated patients having a 1.53-point smaller change than placebo-treated patients.
One of the included studies reported that statin treatment may be most beneficial in patients with high MMSE scores or high cholesterol at baseline, or who possess the E4 allele of the apolipoprotein E gene.
"We await full results of the CLASP 2008 study," the reviewers write in The Cochrane Library.
They say it would be "unwise to embark upon further large-scale randomized controlled trials until full results are known," but add that any future studies should consider the impact of disease stage, apolipoprotein E genotype, and baseline cholesterol levels.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Eleanor McDermid