Hajjar Ihab, Schumpert Jeannie, Hirth Victor, Wieland Darryl, Eleazer G Paul
Palmetto Health Alliance/University of South Carolina, Columbia 29203, USA.
J Gerontol A Biol Sci Med Sci. 2002 Jul;57(7):M414-8. doi: 10.1093/gerona/57.7.m414.
Previous evidence suggests that treatment with 3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitors (statins) has a positive impact on dementia. We decided to investigate the association between the use of statins and the prevalence of dementia and statins' impact on the progression of cognitive impairment.
This is a case-control and a retrospective cohort study of a community-based ambulatory primary care geriatric practice. We included a convenience sample of all patients (N = 655, mean age 78.7 +/- 0.3 years, 85% Caucasian, 74% women) with hypercholesterolemia or dementia, or using statins. We compared those using statins with those who do not with respect to the clinical diagnosis of dementia and its subtypes and the progression of cognitive impairment.
At the initial visit, 35% had dementia, and 17% were using statins. After covariate adjustments, patients on statins were less likely to have dementia (odds ratio [OR] for dementia based on composite definition = 0.23; 95% confidence interval [CI] [0.1-0.56], p =.001, OR Alzheimer's disease = 0.37; 95% CI [0.19-0.74], p =.005, OR vascular dementia = 0.25; 95% CI [0.08-0.85], p =.027). At follow-up, patients on statins showed an improvement on their Mini-Mental Status Examination score by 0.7 +/- 0.4 compared to a decline by 0.5 +/- 0.3 in controls, p =.025 (OR for no change or improvement on statins = 2.81; 95% CI [1.02-8.43], p =.045) and scored higher on the Clock Drawing Test (difference of 1.5 +/- 0.1, p =.036).
The use of statins is associated with a lower prevalence of dementia and has a positive impact on the progression of cognitive impairment.
先前的证据表明，使用3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂（他汀类药物）对痴呆症有积极影响。我们决定研究他汀类药物的使用与痴呆症患病率之间的关联，以及他汀类药物对认知障碍进展的影响。
这是一项基于社区的门诊初级保健老年医学实践的病例对照和回顾性队列研究。我们纳入了所有患有高胆固醇血症或痴呆症或正在使用他汀类药物的患者的便利样本（N = 655，平均年龄78.7±0.3岁，85%为白种人，74%为女性）。我们比较了使用他汀类药物的患者与未使用他汀类药物的患者在痴呆症及其亚型的临床诊断以及认知障碍进展方面的情况。
在初次就诊时，35%的患者患有痴呆症，17%的患者正在使用他汀类药物。经过协变量调整后，使用他汀类药物的患者患痴呆症的可能性较小（基于综合定义的痴呆症优势比[OR] = 0.23；95%置信区间[CI] [0.1 - 0.56]，p = 0.001，阿尔茨海默病的OR = 0.37；95% CI [0.19 - 0.74]，p = 0.005，血管性痴呆的OR = 0.25；95% CI [0.08 - 0.85]，p = 0.027）。在随访中，使用他汀类药物的患者简易精神状态检查表得分提高了0.7±0.4，而对照组下降了0.5±0.3，p = 0.025（他汀类药物无变化或改善的OR = 2.81；95% CI [1.02 - 8.43]，p = 0.045），并且在画钟试验中得分更高（差异为1.5±0.1，p = 0.036）。
使用他汀类药物与较低的痴呆症患病率相关，并且对认知障碍的进展有积极影响。
