Statins and Dementia: Is There a Link?

Key Takeaways

Taking statins could be associated with an increased risk of dementia and cognitive decline. However, there is no concrete scientific evidence supporting this claim.
High blood pressure, diabetes, and high cholesterol levels can increase the risk of impaired blood flow to the brain cells, causing cognitive impairment.
Researchers expect that statins reduce the risk of neurodegenerative diseases, but some studies suggest an increased risk of cognitive impairment related to statins.

Is there a connection between statins and dementia?

Statins are some of the most commonly prescribed drugs in the United States. Approximately 40 million Americans are on statin therapy for cholesterol reduction. But while these cholesterol-lowering medicines help to decrease cardiovascular risk, statin treatment can be a risk factor for dementia, though it remains controversial.

Some studies have shown that taking statins could be associated with an increased risk of dementia and cognitive decline. However, the results are inconsistent. Other studies have found that statins have minimal to no effect on cognitive function.

Experts say that for people who need cholesterol-lowering drugs to reduce the risk of cardiovascular disease, the benefits of taking statins outweigh the risks. This means that while there may be a risk of cognitive decline associated with statins, there is currently no concrete scientific data supporting this claim. On the other hand, statins have been shown to reduce the risk of heart disease, heart attack, and stroke.

Do statins increase the risk of dementia?

The link between statin use and the risk of dementia remains unclear. High blood pressure, diabetes, and high cholesterol levels are known vascular risk factors. They increase the risk of vascular dementia, a condition in which impaired blood flow to the brain cells causes cognitive impairment. Therefore, taking statins should have a protective effect on the central nervous system and lead to a lower neurocognitive risk.

Additionally, evidence suggests that statins reduce inflammation in the brain, which is believed to play a role in the development of Alzheimer’s disease and other forms of dementia.

Therefore, it would appear that statin drugs have brain health benefits and lead to a statistically significant reduced risk of developing Alzheimer’s disease and other types of dementia. However, there are no clinical trials supporting this finding.

In 2012, the FDA issued a warning regarding short-term cognitive impairment reported by statin users. This leads to concern regarding the risk of neurodegenerative diseases associated with statin use. More research is necessary to learn about the relative risk of cognitive impairment related to statin use.

Meanwhile, you should let your doctor know if you experience any changes in your cognitive function. If cognitive impairment is a concern, you should discuss it with your doctor instead of stopping taking statin on your own.

What do the latest studies say about statins and dementia risk?

A 2021 study published in the Journal of the American College of Cardiology included large randomized clinical trials on statin use in more than 18,000 people aged 65 years and older.

The study participants were followed for about 5 years, and researchers found that statin users were not at a higher risk of dementia compared to statin non-users. The study concluded that statin use does not lead to a significant difference in cognitive functioning and is not associated with cognitive decline, including a decline in language, memory, executive function, or psychomotor speed.

The study also found no differences between different statins (lipophilic and hydrophilic statins) in terms of causing mild cognitive impairment or increasing the risk of developing dementia.

Another 2021 systematic review and meta-analysis published in the European Journal of Preventive Cardiology looked at the relationship between statin use and the risk of dementia or Alzheimer’s disease.

This meta-analysis included data from 36 observational studies and found that statins were associated with a decreased risk of dementia. Data from 21 studies found that statin use was associated with a reduced risk of Alzheimer’s disease. There were no differences between men and women in risk reduction. Moreover, the results were similar for lipophilic statins and hydrophilic statins. Stronger results were obtained for high-potency statins compared to low-potency statins.

A 2022 cohort study in Norway of people with familial hypercholesterolemia found no association between statin use and dementia risk.

How do statins help with cardiovascular disease?

Cholesterol is a waxy substance that can accumulate inside arterial walls, causing blockages and reduced blood flow to vital organs such as the heart and brain. This can lead to an increased risk of heart attacks and strokes due to the lack of oxygen supply to the heart and brain, respectively.

According to the American Heart Association and World Health Organization, high blood cholesterol levels are one of the major cardiovascular risk factors, along with high blood pressure, diabetes, obesity, and smoking. These risk factors are linked to a high risk of coronary heart disease, stroke, and vascular disease.

Statins block the action of an enzyme called HMG-CoA (hydroxymethylglutaryl-CoA) reductase, which is needed for cholesterol synthesis in the liver. By blocking the activity of this enzyme, the effects of statins on cholesterol metabolism lead to a reduction in cholesterol levels in the body. This includes low-density lipoprotein cholesterol (LDL or “bad” cholesterol) and triglycerides. Therefore, by reducing cholesterol levels, statins reduce the risk of heart disease, heart attack, and stroke. They are prescribed for both primary and secondary prevention of cardiovascular disease and major cardiovascular events.

What are the most common adverse effects of statins?

Some of the most common adverse effects of statins are muscle aches, headache, dizziness, and gastrointestinal symptoms such as gas, nausea, diarrhea, and constipation.

What vitamins do statins deplete?

Statins may deplete vitamin D and a micronutrient called coenzyme Q10. Studies have shown that many people who experience statin-associated muscle symptoms have vitamin D deficiency and low levels of CoQ10. If you experience muscle aches while taking a statin, you should talk to your doctor about taking vitamin D and CoQ10 supplements.

What to do if statin use causes brain fog?

If taking a statin causes you to experience symptoms such as brain fog, confusion, forgetfulness, and difficulty concentrating, talk to your healthcare provider about lowering your statin dose, switching you to a different statin, or taking a different type of lipid-lowering medication.

What can I take instead of statins to lower cholesterol?

If you are worried you might develop dementia by taking statins, or if you can’t tolerate the side effects of statins, talk to your doctor about alternative treatments for high cholesterol. These include:

Fibrates such as gemfibrozil (Lopid) and fenofibrate (Tricor)
Cholesterol absorption inhibitors such as ezetimibe (Zetia)
Bile acid sequestrants such as cholestyramine (Prevalite, Questran), colestipol (Colestid), and colesevelam (WelChol)
ACL inhibitors such as bempedoic acid (Nexletol)
PCSK9 inhibitors such as evolocumab (Repatha) and alirocumab (Praluent)
Niacin or vitamin B3 (Niaspan, Niacor)
Omega 3 fatty acids (Lovaza)

Keep in mind that there is no strong scientific evidence proving that taking statins is associated with faster cognitive decline. Indeed, some studies show a decreased incidence of dementia with statin use, and the cardiovascular benefits of statin treatment outweigh any potential risks.

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