Statin-Induced Toxic Myopathy Masquerading as Recurrent Falls and De-Conditioning in an Older Adult

Statins, widely prescribed for their efficacy in reducing low-density lipoprotein cholesterol (LDL-C) and preventing atherosclerotic cardiovascular disease, are generally well tolerated. However, muscle-related adverse effects, particularly statin-associated myopathy, can significantly impact patient function and adherence. This case report describes an 83-year-old man who developed progressive proximal muscle weakness, fatigue, and recurrent falls following initiation of high-dose atorvastatin after a ST-elevation myocardial infarction. Clinical and laboratory evaluation, along with the temporal association and improvement after drug withdrawal, supported a diagnosis of self-limited toxic statin myopathy. Extensive differential diagnosis excluded other neuromuscular, endocrine, and vascular causes. Prompt discontinuation of atorvastatin, supportive care, and physiotherapy led to marked functional recovery. This case highlights the spectrum of statin-induced muscle toxicity, emphasises diagnostic vigilance in older adults, and underscores the importance of personalised therapy and early intervention to mitigate adverse outcomes.