Alzheimer’s Australia Official Statement: Statins and Dementia

01 March, 2012
Recently, there have been a number of reports in Australian newspapers stating that medications that lower cholesterol have been linked to dementia (and diabetes). These reports are based upon recent changes to the drug safety labels in the US.

On 28th February, the US Food and Drug Administration (FDA) announced that they were amending the safety information on cholesterol-lowering statin medications. The safety information now contains a statement that statins may have an adverse effect on cognition in a small number of people. However, according to the FDA, these are “generally non-serious and reversible cognitive side effects (memory loss, confusion, etc.)” The FDA have based this advice upon case study reports, do not cite any additional studies that clearly demonstrate an increased risk on cognition.

The release states that individuals who have reported this cognitive change “do not appear to be associated with fixed or progressive dementia, such as Alzheimer’s disease” (1).

The FDA concluded that the cardiovascular benefits of statins outweigh these possible small increased risks. Despite this, a number of Australian newspapers have inaccurately reported that statins are associated with an increased risk of dementia.

The authors of these media articles are confusing reversible cognitive effects with dementia. This is a common mistake, however the differences are significant and there is not even any evidence that reversible cognitive effects are due to statins.

Forgetful moments and occasional confusion are not dementia. Dementia is a syndrome that is almost always progressive and irreversible. Dementia is characterised by a loss of memory, other cognitive functions, or visuo-spatial abilities to an extent that it impairs daily function. Those concerned may wish to discuss their symptoms with their doctors, however they should not cease their cholesterol medication because of concerns about dementia.

Because of the known association between heart disease and Alzheimer’s disease, one study recently trialled statins as a potential treatment for Alzheimer’s disease. The medication was administered to patients with Alzheimer’s disease as it was hoped that the statins would improved cognition. However, the trial found that even when statins were administered at high doses patients performed no better, and no worse than the placebo group (2).

The role of cholesterol in the brain

Cholesterol is essential for cell functioning, and is naturally found in relatively high concentrations in the brain. However, abnormally high levels of cholesterol in the bloodstream is associated with an increased risk of heart disease.  

The relationship between cholesterol and dementia is very complex and not yet fully understood. Although mixed, studies have generally shown that an increase in cholesterol levels is associated with an increased risk of Alzheimer’s disease (3). It is for this reason that Alzheimer’s Australia endorses managing cholesterol levels as a protective measure against dementia. Other health factors that are important are management of blood pressure, watching your diet, and keeping physically and mentally active.

Contact: Dr Chris Hatherly, chris.hatherly@alzheimers.org.au

1. FDA Safety Announcement, 28th February 2012To read the FDA announcement, click here

2. Feldman, H., Doody, R. et al. (2010) Randomized controlled trial of atorvastatin in mild to moderate Alzheimer disease. Neurology 74 (12): 956-964. Online

3. Shepardson, N., Shankar, G., Selkoe, D. (2011) Cholesterol Level and Statin Use in Alzheimer Disease. Archives of Neurology 68 (10): 1239-1244. Online