Du Ye, Yu Zhangjie, Li Chengyi, Zhang Yanxing, Xu Buyun
Department of Neurology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China.
Department of Cardiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China.
Front Pharmacol. 2025 Feb 3;16:1473796. doi: 10.3389/fphar.2025.1473796. eCollection 2025.
The effect of statins on the risk of dementia and Alzheimer's disease (AD) is unclear.
We systematically searched EMBASE, Web of Science, PubMed, CENTRAL and ClinicalTrail.gov for cohort studies comparing incidence of new-onset dementia and AD between statin users and non-users. We applied the DerSimonian-Laird random effects method to pool hazard ratio (HR) with 95% confidence intervals (CI).
We included forty-two studies comprising 6,325,740 patients. Thirty-five cohort studies involving 6,306,043 participants were pooled and indicated that statin use was associated with a reduced risk of dementia (HR: 0.79, 95% CI: 0.71-0.88). Similarly, an analysis of 19 studies comprising 1,237,341 participants demonstrated a 29% decrease in the risk of AD among statin users (HR: 0.71, 95% CI: 0.60-0.85). In sensitivity analyses, diagnostic criteria for dementia/AD significantly affected the combined risk estimates. In subgroup analyses, compared to studies enrolling participants with a mean/median age over 70 years, those younger than 70 years exhibited greater efficacy of statins in preventing dementia (HR: 0.67, 95% CI: 0.56-0.81 vs HR: 0.86, 95% CI: 0.78-0.95; P = 0.02) and AD (HR: 0.47, 95% CI: 0.44-0.50 vs. HR: 0.81, 95% CI: 0.71-0.92; P < 0.01). Due to significant heterogeneity in the definitions of statin dosage and exposure duration, pooling the results was abandoned and most studies suggested that higher dosages and longer exposure duration of statins further reduce the risk of dementia and AD.
Statin use is associated with a reduced incidence of dementia and AD, which might be modified by ages.
他汀类药物对痴呆症和阿尔茨海默病（AD）风险的影响尚不清楚。
我们系统检索了EMBASE、科学网、PubMed、CENTRAL和ClinicalTrail.gov，以查找比较他汀类药物使用者和非使用者中新发痴呆症和AD发病率的队列研究。我们应用DerSimonian-Laird随机效应方法汇总风险比（HR）及其95%置信区间（CI）。
我们纳入了42项研究，共6325740名患者。对涉及6306043名参与者的35项队列研究进行汇总分析，结果表明使用他汀类药物与痴呆症风险降低相关（HR：0.79，95%CI：0.71-0.88）。同样，对包含1237341名参与者的19项研究进行分析表明，他汀类药物使用者患AD的风险降低了29%（HR：0.71，95%CI：0.60-0.85）。在敏感性分析中，痴呆症/AD的诊断标准显著影响合并风险估计值。在亚组分析中，与纳入平均/中位数年龄超过70岁参与者的研究相比，年龄小于70岁的参与者中，他汀类药物预防痴呆症的效果更佳（HR：0.67，95%CI：0.56-0.81对比HR：0.86，95%CI：0.78-0.95；P=0.02），预防AD的效果也更佳（HR：0.47，95%CI：0.44-0.50对比HR：0.81，95%CI：0.71-0.92；P<0.01）。由于他汀类药物剂量和暴露持续时间的定义存在显著异质性，因此未对结果进行汇总，且大多数研究表明，更高剂量和更长暴露持续时间的他汀类药物可进一步降低痴呆症和AD的风险。
使用他汀类药物与痴呆症和AD的发病率降低相关，这可能因年龄而异。
