Statins may lower the risk of developing Alzheimer’s disease, but the decrease in risk varies across statin molecules, and by gender, race, and ethnicity, according to research published online ahead of print December 12 in JAMA Neurology.
None of the statins assessed in the study affected the risk of developing Alzheimer’s disease among black men, said Julie M. Zissimopoulos, PhD, Vice Dean for Academic Affairs and Assistant Professor in the Sol Price School of Public Policy at the University of Southern California in Los Angeles, and her associates.
Julie M. Zissimopoulos, PhD
Several studies have suggested that statins exert a protective effect against Alzheimer’s disease, but they have had insufficient follow-up times, lacked minorities, and removed hyperlipidemic participants. For these reasons, Dr. Zissimopoulos and her colleagues analyzed medical and pharmacy data for a large, diverse sample of Medicare beneficiaries.
The researchers examined 399,979 adults aged 65 and older who initiated statin therapy during a two-year period. Beneficiaries were followed for approximately seven years. The mean interval between statin exposure and Alzheimer’s disease diagnosis was 5.4 years.
The study population included 310,240 non-Hispanic whites, 32,658 Hispanics, 32,278 non-Hispanic blacks, and 24,803 participants of Asian, Native American, other, or unknown race or ethnicity. The investigators confined their analysis to the four most commonly prescribed statins: simvastatin, atorvastatin, pravastatin, and rosuvastatin.
Overall, 1.72% of women and 1.32% of men were diagnosed as having Alzheimer’s disease during each year of follow-up. Study participants who were exposed to higher statin levels during the two-year exposure period were 10% less likely to receive a diagnosis of Alzheimer’s disease during follow-up, compared with those exposed to lower levels of statins. High exposure to statins reduced the risk of Alzheimer’s disease among women of all races (hazard ratio [HR], 0.85) and men of all races (HR, 0.88).
This association, however, varied across gender, race, and ethnicity. Statins decreased the risk of Alzheimer’s disease the most among Hispanic men (HR, 0.71), followed by black women (HR, 0.82), white women (HR, 0.86), and white men (HR, 0.89), but they did not decrease the risk of Alzheimer’s disease among black men, said Dr. Zissimopoulos. Simvastatin significantly decreased the risk of Alzheimer’s disease among white, Hispanic, and black women, compared with other subgroups, and atorvastatin significantly decreased the risk among white women, Hispanic women, and Hispanic men. Pravastatin and rosuvastatin decreased the risk of Alzheimer’s disease significantly among white women only.
These findings suggest that “certain patients facing multiple, otherwise equal statin alternatives for hyperlipidemia treatment, may reduce Alzheimer’s risk by using a particular statin. The right statin type for the right person at the right time may provide a relatively inexpensive means to lessen the burden of Alzheimer’s disease,” the investigators said.
This study was supported by the National Institute on Aging, the University of Southern California Zumberge Research Fund, and the Schaeffer-Amgen Fellowship Program.
—Mary Ann Moon
Suggested Reading
Zissimopoulos JM, Barthold D, Brinton RD, Joyce G. Sex and race differences in the association between statin use and the incidence of Alzheimer disease. JAMA Neurol. 2016 Dec 12 [Epub ahead of print].