Brain, benefit, or burden? Revisiting statins and cognitive function in older adults

Area of Science:

• Gerontology
• Pharmacology
• Neurology

Background:

• Statins are widely used for cardiovascular disease prevention in older adults.
• Concerns exist about statins potentially causing adverse cognitive effects like memory loss and dementia.

Purpose of the Study:

• To critically review evidence on statin use and cognitive outcomes in older adults.
• To explore potential risks, benefits, and biological mechanisms of statins on cognition.

Main Methods:

• Synthesized findings from randomized controlled trials (RCTs), observational studies, meta-analyses, and Mendelian randomization.
• Examined biological mechanisms, statin types, and clinical considerations for older populations.

Main Results:

• Most RCTs show no harmful cognitive effects; observational studies yield mixed results, some suggesting protection.
• Mendelian randomization analyses largely indicate no causal link between statin targets and dementia.
• Older adults are underrepresented in cognitive outcome trials, limiting real-world evidence.

Conclusions:

• Current evidence does not support discontinuing statins due to cognitive concerns in older adults.
• Individualized decisions balancing cardiovascular benefits and cognitive risks are recommended.
• Future research must prioritize cognitive outcomes in older populations.