depressed man, suicide

A friend recently asked us the question: “I would love to find out what you think about the thought-provoking article regarding a breakthrough against Alzheimer’s disease.”

It’s hardly any wonder people are intrigued. The headlines have been tantalizing.

Forbes offered this:

“From Taiwan, A Long Hoped-For Breakthrough In The Fight Against Alzheimer’s”

A doctor’s news service suggested:

“Statins Could Protect Against Dementia”

So what is the straight and skinny on statins and dementia? Will drugs like atorvastatin (Lipitor), lovastatin (Mevacor), pitavastatin (Livalo) rosuvastatin (Crestor) and simvastatin (Zocor) really protect you from cognitive decline or Alzheimer’s disease?

The answer is complicated. The most recent study, published in the journal PLOS (Feb. 2014), was an epidemiological analysis of patients with type 2 diabetes. These Taiwanese subjects were part of the National Health Insurance Research Database. Roughly 16,000 patients with type 2 diabetes had never used statins, while 2,400 diabetic patients regularly used these cholesterol-lowering medications.

Patients with type 2 diabetes are a bit like canaries in the coal mines in that they are at increased risk for developing dementia. In this retrospective study, the investigators found that regular use of statins such as atorvastatin or simvastatin seemed to reduce the risk of Alzheimer’s-type dementia by about 25 percent. There was no such reduction for other forms of dementia such as multi-infarct or vascular dementia. These other kinds of cognitive diseases are responsible for about one third of all dementias.

The findings of this study led the contributor to Forbes to describe statins as “a long hoped-for breakthrough in the fight against Alzheimer’s disease.” He also disclosed that he owns “stock in AstraZeneca, one of the companies mentioned in this commentary.” AstraZeneca makes Crestor, one of the most profitable statins sold in the U.S.

Before we provide color commentary on the question of statins as brain protectors and Alzheimer’s preventers, we need to clarify the difference between a retrospective epidemiological study and a randomized controlled trial (RCT). Epidemiological or observational studies can only suggest a possible association between a drug and an outcome. They cannot prove cause-and-effect.

Many such epi studies reported that hormone replacement therapy (HRT) lowered the risk of heart disease and strokes in women until an actual randomized controlled trial (the Women’s Health Initiative) proved once and for all that HRT actually raised the risk of heart attacks and strokes (and breast cancer).

RCTs are the gold standard when it comes to determining drug benefits. In a “blinded” protocol, patients are randomized to receive either active drug or inactive placebo. Neither doctors nor patients know who gets what.

So, what do the RCTs tell us about statins and Alzheimer’s disease? The PROSPER trial involved 5,804 men and women between 70 and 82 years of age. They were randomized to receive either placebo or 40 mg of pravastatin. After 3.2 years the researchers found that “Pravastatin had no significant effect on cognitive function or disability.”

Another study involving 20,536 high-risk individuals randomized people to either 40 mg of simvastatin or placebo for roughly five years. The investigators found that “…no significant differences were observed between the treatment groups in the percentages of participants classified as cognitively impaired… Similar numbers of participants in each treatment group were reported to have developed dementia during follow-up…”

Finally, an “international, multicenter, double-blind, parallel-group study” involved 640 patients with mild to moderate Alzheimer’s disease who were given either 80 mg of atorvastatin or placebo for 72 weeks. The results:

“Atorvastatin does not slow cognitive decline in patients with mild to moderate probable Alzheimer’s disease…”

An evaluation by the Cochrane Collaboration, a large group of independent experts reviewed all the available data on statins in the treatment of dementia. They concluded:

“There is insufficient evidence to recommend statins for the treatment of dementia. Analysis from the studies available, including one large RCT, indicate statins have no benefit on the outcome measures ADAS-Cog [Alzheimer’s Disease Assessment Scale- cognitive subscale] or MMSE [Mini Mental State Examination].”

People’s Pharmacy Color Commentary:

Observational studies like the one from Taiwan are enticing, but they do not represent a “breakthrough” against Alzheimer’s disease. Such drugs are clearly NOT a cure for the disease. And it remains unclear whether they will actually prevent dementia. If there is an effect, we suspect it might be because of an anti-inflammatory action rather than any cholesterol-lowering effect. We think cholesterol is essential for brain function.

We have also received a great many reports of brain fog, cognitive dysfunction and dementia-like symptoms associated with statins. We cannot prove that statins cause forgetfulness, memory problems or confusion, but many visitors to this website are convinced that they do. Here are links to some pages that suggest such a connection in selected patients.

Are Statins Good or Bad for the Brain?

Transient Global Amnesia (TGA) & Lipitor

FDA Warns of Memory Problems with Statins

Is it Dementia or Is It Statins?

Share your own experiences with statins below. Have you experienced brain fog or memory problems or do you think statins are helping protect you against dementia. We would love to read your story. Those that would like to learn about other ways to control cholesterol may find our Guide to Cholesterol and Heart Health of value.

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  1. Todd P

    Statin drugs under all sorts of names reduce cholesterol but what the FAIL to tell people s that humans brains are made up of more then 95% cholesterol and these drugs destroy that as well.
    –The brains cholesterol holds up and keeps synapses separated and when the cholesterol is destroyed the synapses have nothing supporting them and the fall into each other shorting out parts of the brain causing loss of memory and eventually death.
    –Essentially this drugs DOES cause Dementia and other memory related problems.

  2. Anonomous comenter

    I think all these pro statin studies are paid for by big pharma.

  3. Cheryl Greene

    As always, the People’s Pharmacy Team comes through. I knew when I read the initial article that this was either “hot stuff” or “good try, but …” and I knew exactly where to go for the best possible answer!
    Thanks for the (massive, I’m sure) time you put into researching this important topic. We all want help for Alzheimer’s Disease, but barking up the wrong tree isn’t going to help any of us.
    As always your fan,
    Cheryl Greene

  4. Donnie

    My cousin was fine, until he was put on statins. He developed many of the side-effects and adverse reactions, including cognitive decline. His doctor kept him on the statins, until his death, despite all the terrible things those drugs were doing to him.

  5. Daniel Hessler

    Joe & Terry,
    As one who has taken an anti-statin position, after doing considerable research, this report sounds like yet another foray by the statin sellers to increase sales. So, I essentially agree with your “Color Commentary.”
    That said, I have a MAJOR problem with your example of the Women’s Health Initiative having, “…proved once and for all that HRT actually raised the risk of heart attacks and strokes (and breast cancer)”.
    That study did Not, but rather the WHI study demonstrated an increased risk with Premarin® and Provera®, whereas there was a decreased risk using estrogen alone! Please refer to Dr. Neal Rouzier’s book Natural Hormone Replacement For Men and Women to see how the headlines from the WHI left out the very important difference between artificial and bio-identical hormones.
    Keep up the–otherwise–good work you do.
    Best regards,
    People’s Pharmacy response: You are correct that the Women’s Health Initiative was able to answer the question (Do hormones prevent heart attacks after menopause?) only for Premarin and Provera, since those were the only products tested. The women who took only estrogen (in this case, Premarin) had no protection from heart attacks but also had no increased risk of heart attacks. They did have an increased risk of strokes:
    It seems that people are far more complicated than many of our research protocols can account for!

  6. JR

    Statins have destroyed my husband’s amazing memory. I tried telling our doctor what was happening, but since nothing in the literature indicated it could be so, he insisted that he stay on it. I found some info about a study confirming my belief. I sent it to our doc. and he agreed for him to stop it until he came back in.
    His memory quickly returned to normal. When he saw the doc again, he had him try Lipitor (1st was Crestor). The same problem developed immediately. We have great regard for the doc. but finally stopped the Lipitor over his objections. This second time, he didn’t return to normal and has had a real struggle with short term memory in the years since.
    A noted neurologist has been seeing him for several years and he is insistent that he does not have Alz. nor dementia. Other parts of his brain are as sharp as ever – but memory has been a life changing catastrophe.
    It infuriates me to see the push to get everyone to take these drugs.

  7. Barbara

    All these studies are paid for by drug companies who make the drugs. Why would anyone pay any attention to such studies? The doctor in this study owns stock (probably given to him free by the drug company) in the company who makes the drug, he is paid huge “consulting fees” and the system is so corrupt. There is little if any integrity or honesty in the pharmaceutical industry. The best plan is not to take meds. I took b/p meds for 13 years and then quit and my b/p is lower now than when I took b/p meds. Now my b/p is in the 130s/70s and 80s. On b/p generic meds it was never that low.
    The only other drug I take is Synthroid and I probably never needed that, but I have been on it nearly 50 years and it may not be possible to go off that now.
    Diet, exercise, stress reduction and staying away from toxic people are my medicines now.

  8. VR

    Kudos for a well-written article. People need to be aware that correlation does not necessarily imply causation. Studies must be replicable in order to better rule out other unknown variables. Too much research reaches the public that come from poorly designed studies. These results are often published as fact. Knowing who sponsors the research can be enlightening, as in the prior case.

  9. KC

    I have come to depend on The People’s Pharmacy as the voice of reason when it comes to healthcare questions and answers. Thank you for the research YOU do so I don’t have to. I have often gone to various studies you mention, but I wouldn’t know where to begin when it comes to comparing them in the first place.

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