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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Vydáno v:	Journal of the American Geriatrics Society (JAGS) Ročník 58; číslo 7; s. 1311 - 1317
Hlavní autoři:	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.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Malden, USA Blackwell Publishing Inc 01.07.2010 Wiley-Blackwell
Témata:	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
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Shrnutí:	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.
Bibliografie:	ArticleID:JGS2906 istex:F7AE1A438278CA0F3C48279CA790B530A6CEF9DB ark:/67375/WNG-V5T434K0-F ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0002-8614 1532-5415 1532-5415
DOI:	10.1111/j.1532-5415.2010.02906.x