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Are statins protective or harmful to cognitive function?

Cortney M Mospan1

  • 1Cortney M. Mospan is an assistant professor of pharmacy practice at East Tennessee State University's Bill Gatton College of Pharmacy in Johnson City, Tenn. She also serves as a clinical pharmacist with ETSU's Mooney Pharmacy. The author has disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|December 26, 2015
PubMed
Summary

Statin therapy does not cause cognitive decline, according to recent reviews. Some studies even suggest statins may benefit cognition, despite earlier FDA warnings. This article reviews management strategies for patients on statins with cognitive concerns.

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Area of Science:

  • Cardiovascular Medicine
  • Neuroscience
  • Pharmacology

Background:

  • The U.S. Food and Drug Administration (FDA) mandated safety label changes for statin therapy in February 2012, citing a potential risk of cognitive impairment.
  • Evidence for statin-induced cognitive impairment was primarily based on observational data and case reports.
  • A 2014 National Lipid Association (NLA) safety task force concluded that evidence does not support cognitive decline as a class-wide effect of statins.

Purpose of the Study:

  • To discuss the management of statin therapy in patients with cardiovascular risk.
  • To address concerns regarding cognitive decline or existing cognitive impairment, such as Alzheimer's disease, in patients using statins.

Main Methods:

  • Review of FDA safety communications and NLA task force findings.
  • Analysis of existing scientific literature on statins and cognitive function.
  • Discussion of clinical management strategies for statin users with cognitive issues.

Main Results:

  • Evidence does not support cognitive decline as a class-wide effect of statins.
  • Some research indicates potential cognitive benefits associated with statin use.
  • Observational data and case reports formed the initial basis for safety concerns.

Conclusions:

  • Statin therapy management should consider individual patient cardiovascular risk and cognitive status.
  • Clinicians should be aware of the nuanced relationship between statins and cognition, including potential benefits.
  • Further research may clarify the role of statins in preventing or managing cognitive decline.