At a time when the new cholesterol guidelines have been released, there is now new data from a meta-analysis systematic review on the use of statins and their effects on memory loss or confusion. A previous FDA statement, possibly based upon case reports or unpublished data, stated that there was evidence of a link between statin use and memory problems. This meta-analysis performed by researchers at the University of Pennsylvania included 25 studies, 3 of which were randomized controlled trials, 16 were cohort studies, 4 case-control studies and 2 cross-sectional studies. No increase in occurrence was found in memory, attention or motor speed as well as executive function, global cognition and visuoperception.
Although there is no increase in incidence, it doesn’t mean that the adverse effects on memory and cognition cannot occur. It is important to recognize, however, that this new information that counters the FDA’s previous statements are vital when weighing risks and benefits of initiating statin therapy. Because of the release of the new cholesterol guidelines, this information is important because it shows that there aren’t any adverse outcome related to cognition when initiating statins at low or medium doses. However, the information is limited for high doses of statins, which is when it appears the most serious of adverse effects occur with the most potent statins. In addition, according to the post-marketing data collected by the FDA adverse event database, the incidence of memory and cognition adverse effects of statins were equivalent to that of losartan and clopidogrel, two drugs that have no evidence of causing any sort of cognitive deficits. In the end, it would be ideal if more randomized controlled trials could be conducted with cognitive endpoints specifically in order to truly relate the incidence of statins and cognition issues.
At this point in time, the benefits of statins seem to outweigh the risks of cognitive defects that may possibly occur.
- Meta-analysis of 25 studies showed no increase in incidence of memory or cognitive adverse effects of statins.
- This is especially true of low- and moderate-dose statins, with limited information on high doses.
- The incidence of cognitive deficits was equivalent to that of losartan and clopidogrel, two drugs with no evidence of causing such deficits.
Annals of Internal Medicine, November 2013