Familial hypercholesterolemia, long-term statin use not linked to risk for dementia
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People with familial hypercholesterolemia and those on long-term, high-intensity statins had no greater risk for dementia than matched controls, per a study published in JAMA Network Open.
“Cardiovascular disease risk factors are important in the development of dementia,” Liv J. Mundal, MD, MHA, PhD, of the department of endocrinology, morbid obesity and preventive medicine at Oslo University Hospital in Norway, and colleagues wrote. “One-third of all dementia cases may be associated with CVD risk factors and may, therefore, be preventable. There is a positive association between levels of low-density lipoprotein cholesterol and dementia risk.”
Mundal and colleagues sought to determine whether patients with familial hypercholesterolemia (FH) and elevated levels of LDL cholesterol were at higher risk for dementia and whether use of statins contributed to that risk.
They conducted a prospective cohort study from 2008 to 2018 and examined 3,520 individuals (52.9% women; mean age, 51.8 years at follow-up) with genetically verified FH along with 69,713 age- and sex-matched controls (53% women; mean age, 51.7 years at follow-up) from the general population in Norway.
Follow-up began at the latest among either the registration date for FH diagnosis, Jan. 1 in the year the participant reached age 40 years or Jan. 1, 2008, and concluded with the end point, death from other causes or Dec. 31, 2018. Investigators calculated defined daily doses (DDDs) of statins prescribed during study follow-up for individuals with FH and grouped them by 1 to 4,999 DDDs, 5,000 to 10,000 DDDs and more than 10,000 DDDs.
According to study results, 62 patients with FH and 1,294 controls developed dementia over 10 years of follow-up, and most dementia cases occurred in people aged 70 years and older (39 with FH, 870 in the control group). Researchers found no excess risk for dementia in patients with FH vs. matched controls (HR = 0.9; 95% CI, 0.7-1.2).
Further, there was no association between cumulative DDDs of statins and total dementia in FH patients for cumulative DDDs of 5,000 to 10,000 (HR = 1.2; 95% CI, 0.4-3.8) and DDDs greater than 10,000 (HR = 1.9; 95% CI, 0.7-5).
“We found no excess risk of total dementia, vascular dementia or Alzheimer’s disease-dementia in AD in individuals with genotyped FH compared with age-matched and sex-matched controls,” Mundal and colleagues wrote. “In addition, there was no association between statin use and dementia risk among individuals with FH.”