Age-Varying Association Between Statin Use and Incident Alzheimer's Disease

OBJECTIVES: To determine whether risk reduction of statins for Alzheimer's disease (AD) varies by age or presence of apolipoprotein E (APOE) ɛ4 allele. DESIGN: A cohort of cognitively intact elderly participants was assessed biennially for dementia and AD. SETTING: Community based. PARTICIPANTS...

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Published in:Journal of the American Geriatrics Society (JAGS) Vol. 58; no. 7; pp. 1311 - 1317
Main Authors: Li, Ge, Shofer, Jane B., Rhew, Isaac C., Kukull, Walter A., Peskind, Elaine R., McCormick, Wayne, Bowen, James D., Schellenberg, Gerard D., Crane, Paul K., Breitner, John C.S., Larson, Eric B.
Format: Journal Article
Language:English
Published: Malden, USA Blackwell Publishing Inc 01.07.2010
Wiley-Blackwell
Subjects:
Adult and adolescent clinical studies
Age Factors
Aged
Aged, 80 and over
Alzheimer Disease - epidemiology
Alzheimer Disease - genetics
Alzheimer Disease - prevention & control
Alzheimer's disease
APOE genotype
Apolipoprotein E4 - genetics
Biological and medical sciences
Cohort Studies
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Female
General aspects
Genotype
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Incidence
Male
Medical sciences
Neurology
old age
Organic mental disorders. Neuropsychology
Proportional Hazards Models
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Risk Factors
statin
Human
Nervous system diseases
Typing
Alzheimer disease
Use
Genotype
Statin derivative
Cerebral disorder
Gerontology
Association
statin
Apolipoprotein E
old age
Central nervous system disease
Degenerative disease
Elderly
Alzheimer's disease
Age
Geriatrics
Antilipemic agent
APOE genotype
ISSN:0002-8614, 1532-5415, 1532-5415
Online Access:Get full text
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Summary:OBJECTIVES: To determine whether risk reduction of statins for Alzheimer's disease (AD) varies by age or presence of apolipoprotein E (APOE) ɛ4 allele. DESIGN: A cohort of cognitively intact elderly participants was assessed biennially for dementia and AD. SETTING: Community based. PARTICIPANTS: Three thousand three hundred ninety‐two members of a health maintenance organization (HMO) aged 65 and older and without dementia. MEASUREMENTS: Statin use was identified from the HMO pharmacy database, and proportional hazards models were applied with statin use as a time‐dependent covariate to assess the association between statins and AD and the modifying effects of age and the APOE ɛ4 allele. RESULTS: Over an average of 6.1 years of follow‐up of 3,099 participants, 263 participants developed probable AD. The adjusted hazard ratio (aHR) for statin use was 0.62 (95% confidence interval (CI)=0.40–0.97) for AD in models including demographic characteristics and vascular risk factors as covariates. The strength of the association between statins and AD diminished with age (statin‐by–age at entry interaction P=.04); the aHR in those younger than 80 was 0.44 (95% CI=0.25–0.78), versus 1.22 (95% CI=0.61–2.42) for aged 80 and older. The interaction term for statin use–by–APOE ɛ4 was not significant (P=.65). CONCLUSION: This enlarged study confirms earlier findings that statin therapy in early old age, but not in late age, may be associated with a lower risk of AD. The relationship between statin use and AD was consistent across APOE genotypes.
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ISSN:0002-8614
1532-5415
1532-5415
DOI:10.1111/j.1532-5415.2010.02906.x