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Title | Age-varying association between statin use and incident Alzheimer's disease. |
Publication Type | Journal Article |
Year of Publication | 2010 |
Authors | Li G, Shofer JB, Rhew IC, Kukull WA, Peskind ER, McCormick W, Bowen JD, Schellenberg GD, Crane PK, Breitner JCS, Larson EB |
Journal | J Am Geriatr Soc |
Volume | 58 |
Issue | 7 |
Pagination | 1311-7 |
Date Published | 2010 Jul |
ISSN | 1532-5415 |
Keywords | Age Factors, Aged, Aged, 80 and over, Alzheimer Disease, Apolipoprotein E4, Cohort Studies, Female, Genotype, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Incidence, Male, Proportional Hazards Models, Risk Factors |
Abstract | OBJECTIVES: To determine whether risk reduction of statins for Alzheimer's disease (AD) varies by age or presence of apolipoprotein E (APOE) epsilon4 allele. DESIGN: A cohort of cognitively intact elderly participants was assessed biennially for dementia and AD. SETTING: Community based. PARTICIPANTS: Three thousand three hundred ninety-two members of a health maintenance organization (HMO) aged 65 and older and without dementia. MEASUREMENTS: Statin use was identified from the HMO pharmacy database, and proportional hazards models were applied with statin use as a time-dependent covariate to assess the association between statins and AD and the modifying effects of age and the APOE epsilon4 allele. RESULTS: Over an average of 6.1 years of follow-up of 3,099 participants, 263 participants developed probable AD. The adjusted hazard ratio (aHR) for statin use was 0.62 (95% confidence interval (CI)=0.40-0.97) for AD in models including demographic characteristics and vascular risk factors as covariates. The strength of the association between statins and AD diminished with age (statin-by-age at entry interaction P=.04); the aHR in those younger than 80 was 0.44 (95% CI=0.25-0.78), versus 1.22 (95% CI=0.61-2.42) for aged 80 and older. The interaction term for statin use-by-APOE epsilon4 was not significant (P=.65). CONCLUSION: This enlarged study confirms earlier findings that statin therapy in early old age, but not in late age, may be associated with a lower risk of AD. The relationship between statin use and AD was consistent across APOE genotypes. |
DOI | 10.1111/j.1532-5415.2010.02906.x |
Alternate Journal | J Am Geriatr Soc |
PubMed ID | 20533968 |
PubMed Central ID | PMC3176730 |
Grant List | K23 AG020020-05 / AG / NIA NIH HHS / United States U01 AG016976 / AG / NIA NIH HHS / United States P50 AG005136 / AG / NIA NIH HHS / United States AG20020 / AG / NIA NIH HHS / United States U01 AG006781 / AG / NIA NIH HHS / United States AG06781 / AG / NIA NIH HHS / United States AG16976 / AG / NIA NIH HHS / United States AG05136 / AG / NIA NIH HHS / United States K23 AG020020 / AG / NIA NIH HHS / United States |