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Effect of statins on memory loss questioned
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Memory loss was reported in new users of all lipid-lowering drugs, not just statins, raising questions about the association between statins and memory loss, according to new study data.
“Both statin and nonstatin [lipid-lowering drugs] were strongly associated with acute memory loss in the first 30 days following exposure in users compared with nonusers but not when compared with each other,” Brian L. Strom, MD, MPH, and colleagues wrote in JAMA Internal Medicine. “Thus, either all [lipid-lowering drugs] cause acute memory loss regardless of drug class or the association is a result of detection bias rather than a causal association.”
Brian L. Strom
Strom, chancellor of Rutgers Biomedical and Health Sciences, Rutgers University, Newark, New Jersey, and colleagues assessed whether statin users exhibit acute decline in memory compared with nonusers and users of other lipid-lowering drugs.
In a retrospective cohort study of individuals in the Health Improvement Network database from 1987 to 2013, they compared 482,543 statin users with 482,543 matched nonusers of any lipid-lowering drug, as well as all 26,484 users of nonstatin lipid-lowering drugs.
They also conducted a case-crossover study of 68,028 patients with incident acute memory loss, evaluating exposure to statins immediately before the acute memory loss compared with exposure during three earlier periods.
All drugs linked to memory loss
Compared with nonusers of any lipid-lowering drug, the researchers observed an association among statin users between first exposure to statins and incident acute memory loss within 30 days (adjusted OR = 4.4; 95% CI, 3.01-6.41).
However, when compared with users of nonstatin lipid-lowering drugs, statin users were no more likely to have acute memory loss within the first 30 days of exposure to therapy (adjusted OR = 1.03; 95% CI, 0.63-1.66).
In addition, compared with matched nonusers of any lipid-lowering drug, the researchers observed an between first exposure to statins and incident acute memory loss within 30 days (adjusted OR = 3.6; 95% CI, 1.34-9.7) among those who used nonstatin lipid-lowering drugs.
Strom and colleagues wrote that the case-crossover analysis “showed a weak negative association, which would not be clinically meaningful and could be the result of delays in reporting the symptom.”
Detection bias possible
Strom said in a press release that detection bias is the most likely explanation for previous findings linking statins to memory loss.
The possible explanation “that anything that lowers cholesterol has the same effect on short-term memory … is not scientifically credible because you’re dealing with drugs with completely different structures,” he said. “When patients are put on statins or any new drug, they’re seen more often by their doctor, or they themselves are paying attention to whether anything is wrong. So if they have a memory problem, they’re going to notice it. Even if it has nothing to do with the drug, they’re going to blame it on the drug.”
He concluded that “people who have high cholesterol should be on statins … People shouldn’t steer away from the drug because of false fear of memory problems.” – by Erik Swain
Disclosure: Strom reports receiving research funding from AstraZeneca and Bristol-Myers Squibb and consulting for Abbott, AstraZeneca, Bayer Healthcare, Bristol-Myers Squibb, Novartis and Pfizer. Another researcher reports financial ties with AstraZeneca, Bayer Healthcare, Bristol-Myers Squibb, Merck and Pfizer.
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