Abstract

Tze Jian Chin, Sue Finch, Alexandra Gorelik, Ying Tan and Cassandra Szoeke*

ABSTRACT

Introduction: One in three women has the lifetime risk of developing dementia. Women are also at high risk of having dyslipidemia starting from childbearing until the menopause. Statins are known as the first line of cholesterol treatment and are well tolerated. However, recent research suggests that prolong use of statins might lead to an increased risk of developing neurocognitive disorders. The primary aim of this study was to review and consolidate the existing literature in order to better understand the impact of statins on cognition. Methods: MEDLINE (OVID) and EMBASE were searched from their inception to 9 March 2021. The search criteria comprised of abstracts written in English, with information related to both male and female. This review is registered on PROPSERO (ID: CRD42020132155). Results: Few studies have examined the relationship and cognitive function from mid-life whereby the follow-up time of most statin related studies (67.5%) did not exceed 5 years. Meta-analysis showed that while types of statins did not affect the cognition, there was a gender effect in that those that showed significant association were mainly male (?70%). Conclusion: The findings from this systematic review and meta-analysis suggest that the mixed outcome reported could be due to the studies’ design, the neuropsychological tests administered and the length of follow-up. The significant difference reported in the current statin studies was mainly driven by male statin users. These findings shed light on the importance of having long-term statin studies and the urgent need to focus on female statin users. Abbreviations: ACC/AHA = American College of Cardiology/American Heart Association; AD = Alzheimer’s Disease, CVD = Cardiovascular Disease; JUPITER = Justification for the Use of Statins in Primary Prevention; LDL = Low-Density Lipoprotein; MMSE = Mini Mental State Examination; PRISMA = Preferred Reporting Items for Systematic Review and Meta-Analyses; REGARDS = REasosn for Geographic and Racial Differences in Stroke; SMD = standardised mean difference.