Statins can lower the risk of dementia by 15%, and the earlier in life they are taken the higher the chances of avoiding the disease, a 15-year study suggests.
The number of people living with dementia globally is forecast to nearly triple to 153 million by 2050. But experts believe almost half of dementia cases could be prevented or delayed.
Now research presented in Munich at the world’s largest heart conference suggests that the cholesterol-busting drugs could dramatically reduce the risk of people developing dementia.
Study findings
In the largest study of its kind, more than 132,000 people in Denmark were tracked by researchers between 2006 and 2021. Those who started on statins during the study period were 10% less likely to develop dementia. Those taking them early reduced their risk by 15%. The results were similar in women and men.
The findings were presented on Sunday at the annual congress of the European Society of Cardiology (ESC), and simultaneously published in the Lancet Regional Health Europe journal.
Prof Isabel Goncalves, a member of the ESC communication committee, who was not involved in the research, hailed the findings. “Because statins are widely available and inexpensive, the findings are potentially important,” she said.
How statins work
Statins are already one of the most commonly used drugs in the world. The drugs reduce low-density lipoprotein (LDL) cholesterol levels in the blood, which can lead to plaque buildup in arteries and increase the chance of heart attacks, strokes and heart disease. But statins could also help protect the brain in the long term.
Experts believe this is because there is strong evidence that high LDL cholesterol can increase people’s risk of developing dementia, by hardening or narrowing blood vessels that supply the brain. LDL cholesterol (LDL-C) drives plaque formation, and the resulting disruptions to the brain’s blood supply can increase the risk of dementia.
Previous research from the Lancet dementia commission suggested addressing 14 modifiable risk factors, starting in childhood and continuing throughout life, could prevent or delay 45% of dementia cases.
Expert commentary
“Detecting and treating high levels of LDL-C from midlife is one such highlighted risk factor,” said Dr Tummas Ternhamar, from Copenhagen University hospital, who presented the results of the new research at the conference. All those in the 15-year study had type 2 diabetes. But Ternhamar said the findings strengthened the idea that one day everyone might be offered statins as part of a package of measures – such as staying physically active and eating well – to reduce their risk of dementia.
Speaking to reporters in Munich, he said: “Our study supports the idea that dementia risk is best addressed by targeting several factors at once, and that cholesterol may belong on that list.”
“The Lancet commission already takes that multicomponent view, recommending that high LDL cholesterol be detected and treated from midlife. What our findings also add is that timing matters within that – acting early looks better than acting late.”
Among the 132,585 people followed by Ternhamar and his colleagues, 2.7% went on to develop dementia. Compared with no statin initiation, early statin treatment was associated with a 15% lower relative risk of dementia over 10 years. Late statin initiation was associated with a 10% lower relative risk of dementia over 10 years.
Ternhamar said experts were investigating exactly why statins might lower the risk of dementia. “Statins effectively lower LDL cholesterol and protect against atherosclerosis and atherosclerotic cardiovascular diseases,” he said. “This may in turn protect against cerebrovascular atherosclerosis, ischemic stroke, reduced blood flow, and damage to brain tissue, offering a plausible link to explain our findings.”
Dr Honorine Lebraud, a senior partnerships manager at Alzheimer’s Research UK, who was not involved in the research, said: “This observational study adds to growing evidence linking cardiovascular health and brain health. It reinforces the fact that what is good for the heart is good for the brain.”
“More work is needed to show a direct link between statins and reduced dementia risk. This study offers important clues about how cholesterol and cardiovascular health influence dementia risk, while also showing where future research should focus.”
Prof Bryan Williams, chief scientific and medical officer of the British Heart Foundation, said it was important to remember that this was an observational study, which meant it could show an association but cannot prove that statins themselves reduced the risk of dementia.
“That said, there is evidence from trials that do show that statins reduce the risk of dementia so the findings in this study are certainly plausible.”
