Internal Medicine Department E, Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Lipids Health Dis. 2021 Sep 29;20(1):120. doi: 10.1186/s12944-021-01529-2.
Life expectancy has greatly increased, generating an improvement in screening programs for disease prevention, lifesaving drugs and medical devices. The impact of lowering low-density lipoprotein cholesterol (LDL-C) in the very elderly is not well-established. Our aim was to explore the association of LDL-C, high density lipoprotein cholesterol (HDL-C) and lipid lowering drugs (LLDs) on cognitive decline, malignancies and overall survival.
This was a retrospective cohort study. Our study comprised 1498 (72.7%) males and 561 (27.3%) females, aged ≥70 who had attended the Institute for Medical Screening (IMS), Sheba Medical Center, Israel at least twice during 2013-2019. Data were obtained from the computerized database of the IMS. A manual quality control to identify potential discrepancies was performed.
Overall, 6.3% of the subjects treated with LLDs (95/1421) versus 4.2% not treated (28/638), cognitively declined during the study years. No statistically significant effects of LDL-C, HDL-C and LLDs on cognitive decline were observed after correcting for age, prior stroke and other vascular risk factors. With regard to cancer, after adjusting for confounders and multiple inferences, no definite relationships were found.
This analysis of an elderly, high socioeconomic status cohort suggests several relationships between the use of LLDs and health outcomes, some beneficial, especially, with regard to certain types of cancer, but with a higher risk of cognitive decline. Further studies are warranted to clarify the health effects of these medications in the elderly.
预期寿命大大延长,这使得疾病预防、救命药物和医疗器械的筛查计划得到了改善。降低极低龄人群的低密度脂蛋白胆固醇(LDL-C)的效果尚未得到充分证实。我们旨在探讨 LDL-C、高密度脂蛋白胆固醇(HDL-C)和降脂药物(LLD)与认知能力下降、恶性肿瘤和总生存率之间的关系。
这是一项回顾性队列研究。我们的研究对象为 2013 年至 2019 年期间至少两次到以色列谢巴医疗中心医学筛查研究所(IMS)就诊的年龄≥70 岁的 1498 名(72.7%)男性和 561 名(27.3%)女性。数据来自 IMS 的计算机数据库。我们进行了手动质量控制以识别潜在差异。
总体而言,在接受 LLD 治疗的受试者中(95/1421)有 6.3%(6.3%),在未接受治疗的受试者中(28/638)有 4.2%(4.2%)认知能力在研究期间下降。在校正年龄、既往卒中及其他血管危险因素后,LDL-C、HDL-C 和 LLDs 对认知能力下降均无显著影响。关于癌症,在调整混杂因素和多重推断后,未发现明确的关系。
这项针对高龄、高社会经济地位队列的分析表明,LLD 的使用与某些健康结果之间存在多种关系,其中一些是有益的,特别是某些类型的癌症,但认知能力下降的风险更高。需要进一步的研究来阐明这些药物在老年人中的健康影响。