Statin Use May Decrease Dementia Risk in Certain Patients with RA

A study observed differences in the risk of new-onset dementia by gender and age among statin users with rheumatoid arthritis (RA).

In addition to its effectiveness in cardiovascular disease, “Statin therapy may also reduce the risk of dementia by reducing b-amyloid and serum apolipoprotein levels and exhibiting antithrombotic and anti-inflammatory effects,” the researchers explained. “Some observational studies have found a significant association between the use of statin and a reduced risk of dementia; however, two clinical trials had failed to show its beneficial effects on cognitive function.”

The study authors retrospectively reviewed Taiwanese Bureau of National Health Insurance claims data from January 2003 to December 2016. The primary outcome was risk of dementia.

A total of 264,036 eligible adults with RA were identified. Using propensity-score matching, statin users and non-statin users were matched 1:1, with 25,764 patients in each group. Statin use was not correlated with the risk of new-onset dementia (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.97-1.06).

In subgroup analyses, statin use appeared to have a protective effect for certain patients with RA. Patients aged ≥60 years who were statin users, compared to non-statin users, had a lower risk of dementia (adjusted HR, 0.93; 95% CI, 0.86-1.00; P=0.046). Also among patients aged ≥60 years, male statin users were less likely than female patients to develop dementia (adjusted HR, 0.88; 95% CI, 0.81-0.95; P=0.0015).

When analyzing by disease duration, comparing patients with RA disease duration ≥3 or 1 to 3 years versus <1 year, the risk of developing dementia did not largely differ among patients aged ≥60 years (adjusted HRs, 0.95 and 0.93, respectively; 95% CIs, 0.86-1.04 and 0.85-1.02, respectively) and patients aged 40 to 60 years (adjusted HRs, 1.18 and 1.35, respectively; 95% CIs, 0.80-1.74 and 0.97-1.88, respectively).

The study was published in Lipids in Health and Disease.

“We suggested that statin should be used routinely in older male (> 60 years) patients with RA for the prevention of dementia in clinical practice,” the researchers wrote in their conclusion.