Cholesterol-lowering statin drugs do not negatively affect cognition, and they may even have brain-protective effects in certain people, according to a study in the Journal of the American College of Cardiology published in November 2019. Concerns about statins’ effects on the brain emerged after a few older studies and case reports suggested that these drugs could cause memory problems, prompting the FDA, in 2012, to start requiring that statin labels list “non-serious and reversible” memory loss and confusion as rare side effects. But subsequent, better research has largely squelched this concern.
The new study included 1,037 Australians, ages 70 to 90, who underwent a battery of memory and other cognitive tests at baseline and then every two years over a six-year period. The rate of decline in memory and global cognition was found to be no different among those who took statins (for an average of nine years) compared to those who did not. There was also no association between statin use and loss of brain volume, as assessed by MRI scans in a subgroup of about 500 participants at the start of the study and two years later. Lower brain volume is linked to cognitive impairment and dementia.
What’s more, taking statins was actually associated with a slower rate of decline on certain memory tests in two groups of people at elevated risk for cognitive problems: those with heart disease and those with a key genotype (called ApoE4) linked to increased Alzheimer’s risk.
“These data support the view that worries about cognitive impairment should not limit statin use and raise the possibility that statins may favorably alter cognitive trajectories in a group of elders at high risk of Alzheimer’s disease,” an accompanying editorial stated— though the latter finding will require additional, rigorous studies to confirm.
The new findings build on other research that has concluded that statins don’t impair cognition and may even reduce the risk of dementia. In a review of 16 studies published in 2013 in Mayo Clinic Proceedings, for instance, statins were found to have no effect on cognition in the short term—and in studies lasting three to 25 years, the drugs were associated with a 29 percent reduction in dementia risk. Two other analyses in 2013 reached similar conclusions. Such reassuring findings are important since concerns about cognition are among the top reasons people cite for not filling prescriptions for these potentially lifesaving drugs.