For Older Individuals, Reassuring Information within the Statin Debate

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For Older People, Reassuring News in the Statin Debate

Statins can sometimes cause blood sugar abnormalities, leading to a diagnosis of pre-diabetes or diabetes and possible toxic effects on the liver that require regular blood tests for liver enzymes. A very small percentage of people prescribed a statin develop debilitating muscle pain. An older friend developed statin-induced nightmares. There have also been reports suggesting statin-associated memory problems and cognitive decline, which are a common problem even with age.

Probably the biggest deterrent, however, has been the existence of scant evidence of the role statins could play in elderly people at risk for cardiovascular disease. As with most drug trials of new drugs, relatively few people over 75 were included in early studies that assessed the benefits and risks of statins.

However, the latest reports are very reassuring. One was followed by more than 120,000 French men and women aged 75 to 79 who had been taking statins for up to four years. Among the 10 percent who stopped taking the drug, the risk of being hospitalized for a cardiovascular event was 25 to 30 percent higher than those who continued to take a statin.

Another study in Israel, published in the Journal of the American Geriatrics Society last year, included nearly 20,000 older adults who followed for 10 years. Those who received statin therapy were 34 percent less likely to die from any cause than those who did not stick to a prescribed statin. The benefits have not been reduced for people over the age of 75 and apply equally to women and men.

That year, a study published in JAMA by a team led by Dr. Ariela R. Orkaby of the VA Boston Healthcare System reported that among 326,981 U.S. veterans, median age 81, initiation of statin use was associated with 25 percent fewer deaths all and 20 percent fewer cardiovascular deaths during a follow-up period of nearly seven years.

However, none of these studies represent “gold standard” research. The results of two such studies, the Staree Study and the Preventable Study, both randomized controlled clinical trials of statin therapy for the prevention of cardiovascular events in the elderly, have not yet been published. Both will also evaluate the effects on cognition.

A report from Australia published last year in the Journal of the American College of Cardiology found no difference in the rate of memory decline or cognitive status between statin users and those who never took the medication over a six-year period. In fact, among those who started a statin during the study, the rate of memory decline was blunted. Another observational study by a Swedish team published in Nature found positive effects on reaction time and fluid intelligence in statin users over 65 years of age.

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