Lipid Lowering Therapy and Risk of Acute Memory Impairment

Prior data on the use of statin drugs and risk of acute memory impairment has been inconsistent.  In this study, Strom and colleagues sought to investigate use of statins in association with acute memory impairment and compare results to non-users and users of non-statin lipid lowering drugs (LLDs).  The authors performed a retrospective cohort study through The Health Improvement Network database (composed of primary medical records from general practitioners in the United Kingdom) identifying 482,543 patients with newly prescribed statin drugs without underlying cognitive dysfunction or dementia.  Propensity-matched control groups included 482,543 non-users of any LLDs and 26,484 users of non-statin LLDs.  The primary outcome of the analysis was the onset of acute, reversible memory impairment as determined by review of diagnosis codes. Exposure to statins was strongly associated with incident acute memory loss within 30 days of first use compared to matched non-users of LLDs (OR 4.40, CI 3.01-6.41).  The relationship persisted for users of non-statin LLDs compared to non-users (OR 3.60, CI 1.34-9.70) but was not reproduced in comparing statins with non-statin LLDs (OR 1.03, CI 0.63-1.66).

 

Conclusions: When compared to non-users of LLDs, statin and non-statin lipid lowering medications are associated with the development of acute memory loss in the first 30 days after drug exposure.  Although the mechanism of this association is incompletely understood, one potential is for lowering of cholesterol levels to impact neurocognitive function.  Accordingly, it will be particularly important to monitor for neurocognitive complications with the advent of even more potent medications  for cholesterol lowering (i.e. PSK9 inhibitors).

 

Summarized by Amneet Sandhu and Steven M. Bradley

 

Strom BL, Schinnar R, Karlawish J, Hennessy S, Teal V and Bilker WB.  Statin Therapy and Risk of Acute Memory Impairment.  JAMA Intern Med.  2015; 175 (8): 1399-1405.