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O3‐06‐08: Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline
Author(s) -
Debette Stéphanie,
Seshadri Sudha,
Beiser Alexa,
Au Rhoda,
Himali Jayandra,
Palumbo Carole,
Wolf Philip,
S Decarli Charles
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.05.1431
Subject(s) - medicine , framingham risk score , cognitive decline , cardiology , brain size , risk factor , odds ratio , framingham heart study , atrophy , dementia , logistic regression , magnetic resonance imaging , psychology , disease , radiology
dementia and Alzheimer disease (AD) in elderly African Americans. Methods: A community-based sample of 1473 African Americans aged 70 or older residing in Indianapolis, Indiana was assessed in 2001, 2004, 2007, and 2009. Subjects were evaluated using the Community Screening Interview for Dementia (CSI-D), and an in-home assessment including a brief neurological examination, neuropsychological testing, and informant interview. Medication use, including statins, was recorded using participant and informant report, medical record review, and in-home inspection of medications. Incident dementia and AD were defined as the first time a subject was diagnosed with dementia or AD in 2004, 2007, or 2009; diagnoses were determined in consensus diagnosis conferences. Measurements of low-density lipoprotein cholesterol (LDL) and C-reactive protein (CRP) were obtained from baseline blood samples. 974 subjects with complete information on statin use, APOE status, LDL, and CRP were included in this analysis. Results: After controlling for age at diagnosis, education level, and the presence of the ApoE E4 allele, continuous use of statins since baseline was associated with a significantly decreased risk of incident AD (OR1⁄40.27; p1⁄40.0339), and a trend toward a decreased risk of incident dementia (OR1⁄40.40; p1⁄40.0599) compared to those who had never taken stains. Use of statins during only a portion of the assessment period did not confer a significant reduction in risk of either incident AD (OR1⁄40.73; p1⁄40.3123) or for incident dementia (OR1⁄40.72; p1⁄40.2548). There was no significant interaction with baseline LDL or CRP level. Conclusions: In this study, exposure to statin medications conferred a reduced risk for incident AD and a trend toward a reduced risk for incident dementia, but only with consistent use of the medication. The potential mechanism for this risk reduction has not been elucidated completely, but is likely to extend beyond statins’ lipid-lowering effects.