De Spiegeleer Anton, Bronselaer Antoon, Mahieu Ine, Vreys Dorien, Haslbauer Aaron, Leibfarth Jan-Philipp, Van Schoote Lara, Wakjira Aster, Petrovic Mirko, Wynendaele Evelien, De Spiegeleer Bart, Van Den Noortgate Nele, Kressig Reto W, Rössler Roland
Translational Research in Immunosenescence, Gerontology and Geriatrics (TRIGG) Group, Ghent University, Ghent, Belgium.
Department of Geriatrics, Ghent University Hospital, Ghent, Belgium.
Geroscience. 2025 May 7. doi: 10.1007/s11357-025-01682-x.
Statins are frequently prescribed to older adults, yet their effects on ageing phenotypes such as frailty or physiological reserves remain poorly understood. Gait Speed Reserve (GSR), defined as the difference between maximal and usual gait speeds, serves as an indicator of physiological reserve, reflecting the body's ability to perform beyond baseline functional levels. Polypharmacy, prevalent in this population, may contribute to inconsistent findings through interactions between statins and concomitant medications. We aimed to investigate how concomitant medications moderate the association between statin use and GSR in older adults. To this end, we conducted a cross-sectional observational cohort study using data from the Mobility Center at the University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland (n = 5519 adults aged ≥ 60 years). Moderation regression analyses with propensity score weighting were used to evaluate the effect of concomitant medications on the association between statin use and GSR. Results showed statin use was associated with a lower GSR compared to non-use (- 1.9 cm/s [95% CI, - 3.1 to - 0.72]). However, ACE inhibitors and aspirin significantly influenced this association. The GSR difference for statin users compared to non-users increased by 3.7 cm/s (from - 2.2 to 1.5 cm/s; 95% CI, 0.0 to 7.4) with concomitant ACE inhibitor use and by 5.8 cm/s (from - 3.4 to 2.3 cm/s; 95% CI, 2.5 to 9.1) with aspirin use. We found no statistically significant association between statin use and usual gait speed, the secondary outcome. In conclusion, ACE inhibitors and aspirin interacted with statins, reversing the negative association with GSR into a positive one when co-used. Future clinical trials are needed to determine causality and further investigate the impact of concomitant medication use on statin effects in aging populations. Meanwhile, our findings underscore the importance of considering concomitant medication use when assessing the effects of statins in older adults.
他汀类药物经常被开给老年人，但它们对诸如衰弱或生理储备等衰老表型的影响仍知之甚少。步态速度储备（GSR）定义为最大步态速度与通常步态速度之间的差异，是生理储备的一个指标，反映了身体在基线功能水平之上执行功能的能力。多重用药在该人群中很普遍，可能通过他汀类药物与同时服用的其他药物之间的相互作用导致结果不一致。我们旨在研究同时服用的其他药物如何调节老年人中他汀类药物使用与GSR之间的关联。为此，我们使用了瑞士巴塞尔费利克斯·普拉特老年医学大学系移动中心的数据进行了一项横断面观察性队列研究（n = 5519名年龄≥60岁的成年人）。采用倾向评分加权的调节回归分析来评估同时服用的其他药物对他汀类药物使用与GSR之间关联的影响。结果显示，与未使用他汀类药物相比，使用他汀类药物与较低的GSR相关（-1.9厘米/秒[95%置信区间，-3.1至-0.72]）。然而，血管紧张素转换酶（ACE）抑制剂和阿司匹林显著影响了这种关联。与未使用ACE抑制剂的他汀类药物使用者相比，同时使用ACE抑制剂时，GSR差异增加了3.7厘米/秒（从-2.2至1.5厘米/秒；95%置信区间，0.0至7.4），同时使用阿司匹林时增加了5.8厘米/秒（从-3.4至2.3厘米/秒；95%置信区间，2.5至9.1）。我们发现他汀类药物使用与次要结局即通常步态速度之间没有统计学上的显著关联。总之，ACE抑制剂和阿司匹林与他汀类药物相互作用，在共同使用时将与GSR的负相关转变为正相关。需要进一步的临床试验来确定因果关系，并进一步研究同时服用其他药物对老年人群中他汀类药物效果的影响。同时，我们的研究结果强调了在评估他汀类药物对老年人的效果时考虑同时服用其他药物的重要性。
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