PMID- 32039479
OWN - NLM
STAT- MEDLINE
DCOM- 20201222
LR  - 20210110
IS  - 1532-5415 (Electronic)
IS  - 0002-8614 (Linking)
VI  - 68
IP  - 3
DP  - 2020 Mar
TI  - Benefits and Harms of Statins in People with Dementia: A Systematic Review and 
      Meta-Analysis.
PG  - 650-658
LID - 10.1111/jgs.16342 [doi]
AB  - OBJECTIVES: More people with dementia also fall into the category of high 
      vascular risk, for which a statin is usually prescribed. However, these 
      recommendations are based on studies in people without dementia. We aimed to 
      evaluate the evidence for the long-term effectiveness and harm of statin therapy 
      in patients with dementia. DESIGN: Systematic review of randomized controlled 
      trials and observational research. SETTING: Publications from developed countries 
      indexed in the PubMed, Web of Science, and Cochrane trial database between 2007 
      and 2019. PARTICIPANTS: Trials including people with all types of dementia with a 
      mean age older than 65 years. INTERVENTION: Treatment with a statin for 6 months 
      or longer. MEASUREMENTS: Major adverse cardiovascular events, dementia 
      progression, and general health at 2 years, or medication adverse events (AEs) at 
      any time. Each article was assessed for bias using the Newcastle-Ottawa or 
      Cochrane Collaboration tools. A narrative synthesis and pooled analyses are 
      reported. RESULTS: Five articles met the inclusion criteria. They reported only 
      on dementia of the Alzheimer's type. There was no evidence regarding 
      cardiovascular events or general health. We made a very low confidence finding 
      that statins reduce dementia progression based on three cohort studies of 
      heterogeneous design. We made a very low confidence finding of no significant 
      difference in AEs based on two randomized controlled trials of 18 months: odds 
      ratios of any AE = 1.21 (95% confidence interval [CI] = .83-1.77), serious AE = 
      1.03 (95% CI = .76-1.87), and death = 1.69 (95% CI = .79-3.62). CONCLUSION: 
      Evidence was insufficient to fully evaluate the efficacy of statins in people 
      with dementia. We found that statins may have a small benefit delaying 
      progression in Alzheimer's dementia, although this conflicted with previous 
      findings from shorter randomized trials. For safety, the trial data lacked power 
      to show clinically important differences between the groups. We recommend that 
      clinical data be leveraged for further observational studies to inform 
      prescribing decisions. J Am Geriatr Soc 68:650-658, 2020.
CI  - (c) 2020 The American Geriatrics Society.
FAU - Davis, Katrina A S
AU  - Davis KAS
AUID- ORCID: 0000-0001-5945-4646
AD  - King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, 
      London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Bishara, Delia
AU  - Bishara D
AD  - King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, 
      London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Perera, Gayan
AU  - Perera G
AD  - King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, 
      London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
FAU - Molokhia, Mariam
AU  - Molokhia M
AD  - King's College London (KCL) School of Population Health and Environmental 
      Sciences, London, UK.
FAU - Rajendran, Lawrence
AU  - Rajendran L
AD  - King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, 
      London, UK.
AD  - UK Dementia Research Institute, multisite, UK.
FAU - Stewart, Robert J
AU  - Stewart RJ
AD  - King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, 
      London, UK.
AD  - South London and Maudsley NHS Foundation Trust, London, UK.
LA  - eng
GR  - MC_PC_17214/MRC_/Medical Research Council/United Kingdom
GR  - DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20200210
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
SB  - IM
MH  - Alzheimer Disease/*complications
MH  - Cardiovascular Diseases/*drug therapy
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*adverse effects/*therapeutic use
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - dementia
OT  - multimorbidity
OT  - polypharmacy
OT  - statin
OT  - systematic review
EDAT- 2020/02/11 06:00
MHDA- 2020/12/23 06:00
CRDT- 2020/02/11 06:00
PHST- 2019/11/04 00:00 [received]
PHST- 2019/12/22 00:00 [revised]
PHST- 2019/12/30 00:00 [accepted]
PHST- 2020/02/11 06:00 [pubmed]
PHST- 2020/12/23 06:00 [medline]
PHST- 2020/02/11 06:00 [entrez]
AID - 10.1111/jgs.16342 [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 2020 Mar;68(3):650-658. doi: 10.1111/jgs.16342. Epub 2020 Feb 
      10.