Is there a link between statins and dementia?

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Statins treat high cholesterol, lowering the risk of heart disease and stroke.

These medications work to reduce the levels of low-density lipoprotein (LDL) cholesterol, which people may refer to as “bad” cholesterol. Excess LDL can build up in the artery walls, which restricts blood flow and can lead to a stroke or heart attack.

The evidence is mixed when it comes to statins and the risk of developing dementia.

Some researchers have proposed that statins may lead to memory loss if the medication causes extremely low cholesterol levels, which can affect the brain. Another suggestion is that statins cross the blood-brain barrier and cause toxicity in the brain. However, these theories need further supporting evidence.

Over the course of a 4.5-year follow-up of 18,846 people taking statins, the medication had no link with dementia or changes in cognitive function, although there was an increased risk of Alzheimer’s disease.

However, the authors note that the people taking statins were more likely to have other conditions that increase the risk of cognitive decline, such as diabetes, obesity, and high blood pressure.

Concerns about statins and cognitive function may have come from the Food and Drug Administration (FDA), which issued a warning in 2012 following reports of short-term cognitive impairment with statin use.

However, the FDA noted that the benefits of statins for cardiovascular health outweigh any risks of cognitive impairment.

A 2021 article states that reports of memory changes due to statin use are inconsistent. There have been cases of memory deterioration and slowed thinking.

Statins may help prevent heart attack and stroke. The prevention of stroke is an important factor in preserving memory and cognitive function.

A 2019 article states that there is no evidence to suggest a link between statins and cognitive impairment. Similarly, the authors of a 2021 article conclude that there is not enough evidence to make a solid conclusion on the effect of statins on cognitive function or dementia.

Anyone taking statins and experiencing any symptoms of cognitive impairment should talk with the prescribing doctor.

The doctor may carry out tests to check for any underlying causes. In some cases, they may consider switching people to a different statin to see whether the symptoms resolve.

There are different types of statins, some of which will not be suitable for everyone. If a certain type of statin is causing unwanted side effects, a doctor may suggest switching to a different type.

Hydrophilic statins dissolve in water, and lipophilic statins dissolve in lipids. The body absorbs hydrophilic statins more quickly, whereas lipophilic statins are harder for the body to excrete. If a person has kidney failure, lipophilic statins may not be suitable.

If statins are not a suitable option for someone, a doctor may also prescribe a non-statin medication that lowers cholesterol, such as:

• ezetimibe
• alirocumab
• evolocumab
• bempedoic acid
• inclisiran

In addition, people can make lifestyle adjustments to help lower cholesterol and support cardiovascular health. Examples include:

• eating a heart-healthy diet consisting of vegetables, fruit, whole grains, fish, poultry, nuts, and vegetable oils
• limiting the intake of saturated fats, trans fats, fried foods, red meat, and dairy containing whole milk
• increasing physical activity, aiming for at least 150 minutes of aerobic exercise each week
• quitting smoking or avoiding secondhand smoke
• reaching or maintaining a moderate weight
• talking with a healthcare professional about managing cholesterol and keeping the levels within a healthy range

Some research suggests that there may be a link between taking statins and having an increased risk of Alzheimer’s disease. However, further research is necessary to confirm this.

Any existing correlation may also be due to the use of statins by people who already have an increased risk or the number of people who begin statin treatment at an older age, when the likelihood of dementia is already higher.

A 2021 systematic review in the BMJ looked at the side effects of statins and concluded that adverse events were low and that the benefits of statins generally outweigh any risks.

The research around statins and cognitive impairment is inconsistent, but the risk of statins leading to dementia appears low.

Much research suggests that the benefits of statins generally outweigh any risks for people who need them.

Overall, the research seems to suggest that there is limited evidence linking statin use to cognitive impairment or dementia.

If people have any concerns about the side effects of statins or experience any changes to cognitive function while taking them, they should talk with a doctor.