How Common is Statin Use in the Oldest Old?

There is a lack of evidence surrounding the efficacy of statins in the oldest old (≥ 80 years of age). As such, there is controversy surrounding use of statins in this population. We sought to evaluate the prevalence of statin use in the oldest old worldwide to understand the scope of this issue. We searched PubMed and grey literature over the last 5 years. Studies had to report the prevalence of statin use in adults ≥ 80 years of age. The first author performed screening and extracted data. Our search produced 1870 hits; 14 articles were considered eligible. We found three studies of nursing home residents, eight studies of community-dwelling patients and three studies in the combined population (i.e., both community-dwelling patients and nursing home residents). The prevalence of statin use ranged from 17 to 39% in nursing home residents, 12 to 59% for community-dwelling patients and 18 to 45% in combined populations. Beyond age 80 years, the prevalence of statin use appeared to decrease with advancing age. Statin use was more common as secondary prevention compared with primary prevention. The prevalence of statin use in the oldest old has increased over recent decades. The increase in prevalence appears to be more pronounced in the oldest old compared with younger old, as reported by two studies. Statins are widely used in the oldest old despite the lack of evidence in this population. Given how common statin use is in the oldest old, clinical evidence surrounding their efficacy in this group is urgently needed to guide appropriate use and shared decision-making.