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Statins and cognitive decline in patients with Alzheimer's and mixed dementia [Elektronski vir] : a longitudinal registry-based cohort studyPetek, Bojana ...Background: Disturbances in brain cholesterol homeostasis may be involved in the pathogenesis of Alzheimer's disease (AD). Lipid-lowering medications could interfere with neurodegenerative processes ... in AD through cholesterol metabolism or other mechanisms. Objective: To explore the association between the use of lipid-lowering medications and cognitive decline over time in a cohort of patients with AD or mixed dementia with indication for lipid-lowering treatment. Methods: A longitudinal cohort study using the Swedish Registry for Cognitive/Dementia Disorders, linked with other Swedish national registries. Cognitive trajectories evaluated with mini-mental state examination (MMSE) were compared between statin users and non-users, individual statin users, groups of statins and non-statin lipid-lowering medications using mixed-effect regression models with inverse probability of drop out weighting. A dose-response analysis included statin users compared to non-users. Results: Our cohort consisted of 15,586 patients with mean age of 79.5 years at diagnosis and a majority of women (59.2 %). A dose-response effect was demonstrated: taking one defined daily dose of statins on average was associated with 0.63 more MMSE points after 3 years compared to no use of statins (95% CI: 0.33;0.94). Simvastatin users showed 1.01 more MMSE points (95% CI: 0.06;1.97) after 3 years compared to atorvastatin users. Younger (< 79.5 years at index date) simvastatin users had 0.80 more MMSE points compared to younger atorvastatin users (95% CI: 0.05;1.55) after 3 years. Simvastatin users had 1.03 more MMSE points (95% CI: 0.26;1.80) compared to rosuvastatin users after 3 years. No differences regarding statin lipophilicity were observed. The results of sensitivity analysis restricted to incident users were not consistent. Conclusions: Some patients with AD or mixed dementia with indication for lipid-lowering medication may benefit cognitively from statin treatment; however, further research is needed to clarify the findings of sensitivity analyses.Vir: Alzheimer's research & therapy [Elektronski vir]. - ISSN 1758-9193 (Vol. 15, iss. 1, [article no.] 220, 2023, str. 1-16)Vrsta gradiva - e-članekLeto - 2023Jezik - angleškiCOBISS.SI-ID - 185721091
Avtor
Petek, Bojana |
Häbel, Henrike |
Xu, Hong |
Villa-Lopez, Marta |
Kalar, Irena |
Hoang, Minh Tuan |
Maioli, Silvia |
Carvalho, Joana |
Mostafaei, Shayan |
Gregorič Kramberger, Milica
Teme
Alzheimer's disease |
cholesterol metabolism |
cognitive impairment |
cohort study |
HMG-CoA reductase inhibitors |
statins |
Alzheimerjeva bolezen |
presnova holesterola |
kognitivne motnje |
kohortna študija |
zaviralci reduktaze HMG-CoA |
statini
Vnos na polico
Trajna povezava
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Petek, Bojana | 56818 |
Häbel, Henrike | |
Xu, Hong | |
Villa-Lopez, Marta | |
Kalar, Irena | |
Hoang, Minh Tuan | |
Maioli, Silvia | |
Carvalho, Joana | |
Mostafaei, Shayan | |
Gregorič Kramberger, Milica | 28624 |
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