Statin therapy on dementia in elderly type 2 diabetes patients with delirium

Diabetes-related delirium presents a significant challenge in older adults with type 2 diabetes mellitus (T2DM) due to its strong association with cognitive decline and increased dementia risk. Statins, known for their lipid-lowering and neuroprotective properties, may reduce this risk, but their impact in high-risk populations like older T2DM patients with a history of delirium is not fully understood.

The study included individuals aged 65 and older with T2DM and a history of hospitalization for delirium between January 1, 2008, and December 31, 2019, with follow-up until December 31, 2022. Statin use was defined as at least 28 cumulative defined daily doses (cDDD) per year. Propensity score matching (PSM) was used to balance baseline characteristics between statin users and non-users.

The study cohort comprised 35,426 matched pairs of statin users and non-users. Statin use was associated with a reduced risk of dementia (adjusted hazard ratio [aHR], 0.80; 95% CI, 0.75-0.85; p < 0.0001) and lower all-cause mortality (aHR, 0.57; 95% CI, 0.54-0.60; p < 0.0001). A dose-response relationship was observed, with higher cDDD of statins correlating with greater reductions in dementia risk.

Statin therapy, particularly at higher doses and intensities, is linked to reduced dementia risk and overall mortality in older T2DM patients with a history of delirium. These findings support the potential role of statins in the prevention of dementia in this high-risk population, warranting further investigation through randomized controlled trials.