Statins and Memory Impairment

Bo Lively, Mercer University College of Pharmacy

The statin drugs are considered to be effective, well-tolerated, and popular for treating dyslipidemia.  Statins work by inhibiting a rate-limiting step in the biosynthesis of cholesterol.  Simvastatin, pravastatin, lovastatin, atorvastatin, fluvastatin, pitavastatin, and rosuvastatin are the current available statins.  While much is known on the common adverse events associated with statin use, less is known about the possibility for statins to induce reversible memory impairment.1

Title: Statin Therapy and Risk of Acute Memory Impairment2
Design Retrospective cohort study
Objective Researchers wanted to assess whether statin users show acute decline in memory compared with nonusers and with users of nonstatin lipid-lowering drugs (LLDs).
Study Groups Persons receiving newly prescribed statins were compared with a group of nonusers.

New users of statins (n = 482,543) were matched and compared with a group of nonusers (n = 482,543)

Methods Data was collected from The Health Improvement Network (THIN), a database composed of medical records from general practitioners in the United Kingdom. Read codes Clinical Terms (the standard clinical terminology system used by GPs in the United Kingdom) was used, and codes with descriptions specifically pertaining to memory loss including amnesia, amnesia symptom, memory loss symptom, temporary loss of memory, short-term memory loss, transient global amnesia, drug-induced amnestic syndrome, nonalcoholic amnestic syndrome, amnesia (retrograde), memory lapses, minor memory lapses, and mild memory disturbance were included.
Duration Data from January 1987 through December 2013 was included.
Primary Outcome Measure Onset of acute, reversible memory impairment
Baseline Characteristics The distributions of demographic parameters for statin users and nonusers were similar because of matching, but statin users were significantly older (305 904 [63.4%] vs 151 162 [57.3%], respectively, were >60 years).  Statin users had substantially higher proportions of persons with diagnoses suggesting a medical indication for an LLD as well as a higher prevalence of other diseases and drugs.
Results Comparing statin users with matched nonusers of any LLDs across all time periods, the odds ratio (OR) (95% CI) was 1.23 (1.18-1.28). There was a large, statistically significant, increased risk only during the 30-day window immediately following the first exposure (fully adjusted, 4.40; 3.01-6.41).
Adverse Events Not reported
Study Author Conclusions This study revealed a nearly fourfold increase in the risk of developing acute memory loss in the 30 days immediately following the first statin exposure when comparing statin users with nonusers of LLDs.

This study showed a correlation between statin use and acute memory loss within the first 30 days of drug initiation.  The data in this study was retrospectively reviewed. A randomized prospective study examining this possible effect of statins is warranted.

References

1.) Bersot TP.Chapter 31. Drug Therapy for Hypercholesterolemia and Dyslipidemia. In: Brunton LL, Chabner BA, Knollmann BC.  Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12eNew York, NY: McGraw-Hill; 2011.

2.) Strom BL, Schinnar R, Karlawish J, Hennessy S, Teal V, Bilker WB. Statin Therapy and Risk of Acute Memory Impairment. JAMA Intern Med. 2015;

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