Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.
Neuroepidemiology. 2020;54(3):214-226. doi: 10.1159/000503105. Epub 2019 Oct 1.
The impact of statin on dementia risk reduction has been a subject of debate over the last decade, but the evidence remains inconclusive. Therefore, we performed a meta-analysis of relevant observational studies to quantify the magnitude of the association between statin therapy and the risk of dementia.
We systematically searched for relevant studies published from January 2000 to March 2018 using EMBASE, Google, Google Scholar, PubMed, Scopus, and Web of Science. Two authors performed study selection, data abstraction, and risk of bias assessment. We then extracted data from the selected studies and performed meta-analysis of observational studies using a random-effects model. Subgroup and sensitivity analyses were also conducted.
A total of 30 observational studies, including 9,162,509 participants (84,101 dementia patients), met the eligibility criteria. Patients with statin had a lower all-caused dementia risk than those without statin (risk ratio [RR] 0.83, 95% CI 0.79-0.87, I2 = 57.73%). The overall pooled reduction of Alzheimer disease in patients with statin use was RR 0.69 (95% CI 0.60-0.80, p < 0.0001), and the overall pooled RR of statin use and vascular dementia risk was RR 0.93 (95% CI 0.74-1.16, p = 0.54).
This study suggests that the use of statin is significantly associated with a decreased risk of dementia. Future studies measuring such outcomes would provide useful information to patients, clinicians, and policymakers. Until further evidence is established, clinicians need to make sure that statin use should remain restricted to the treatment of cardiovascular disease.
他汀类药物对降低痴呆风险的影响在过去十年一直存在争议，但证据仍不明确。因此，我们对相关观察性研究进行了荟萃分析，以量化他汀类药物治疗与痴呆风险之间的关联程度。
我们系统地检索了 2000 年 1 月至 2018 年 3 月期间发表的相关研究，使用了 EMBASE、Google、Google Scholar、PubMed、Scopus 和 Web of Science。两位作者进行了研究选择、数据提取和偏倚风险评估。然后，我们从选定的研究中提取数据，并使用随机效应模型对观察性研究进行荟萃分析。还进行了亚组和敏感性分析。
共有 30 项观察性研究，包括 9162509 名参与者（84101 名痴呆患者）符合入选标准。使用他汀类药物的患者痴呆的全因风险低于未使用他汀类药物的患者（风险比 [RR] 0.83，95%CI 0.79-0.87，I2 = 57.73%）。他汀类药物使用者阿尔茨海默病的总体综合降低率为 RR 0.69（95%CI 0.60-0.80，p < 0.0001），他汀类药物使用者和血管性痴呆风险的总体综合 RR 为 RR 0.93（95%CI 0.74-1.16，p = 0.54）。
本研究表明，他汀类药物的使用与痴呆风险的降低显著相关。未来测量此类结果的研究将为患者、临床医生和决策者提供有用的信息。在进一步的证据建立之前，临床医生需要确保他汀类药物的使用仍然限于心血管疾病的治疗。
