Psychiatric News March 21, 2003
Volume 38 Number 6
© 2003 American Psychiatric Association
p. 31
Statin Studies Show Mixed Results
A number of animal studies have indicated that the amount of Aß produced in the brain is affected by the amount of cholesterol absorbed from the animals’ diet. Yet studies of cholesterol-lowering medications in human clinical trials have been conflicting as well as disappointing.
Reducing cholesterol intake has been shown in rabbits, mice, and guinea pigs to reduce total brain levels of Aß (see story above). At least one study in animals has shown that atorvastatin (Lipitor) reduces actual plaque formation as well.
On the human side, at least two retrospective studies, both published in 2000, have indicated that patients who had taken coenzyme-A reductase inhibitors, more commonly known as "statins," experienced as much as a 70 percent decrease in the prevalence of Alzheimer’s. However, a recent report by James Shepherd, M.D., professor and chair of the department of pathologic biochemistry at the University of Glasgow, indicates the question of benefit is still not well answered.
Shepherd, the principle investigator of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), reported at last November’s meeting of the American Heart Association that pravastatin (Pravachol) did not appear to help cognition. The drug did result in a 19 percent reduction in death due to coronary artery disease.
Shepherd had hypothesized that of the 5,800 patients in the study, those taking pravastatin would see a slowing of age-related cognitive decline, relative to those receiving placebo, over a three-year period. At the end of the study, however, scores on the Mini-Mental Status Exam (MMSE) were not significantly different between the two groups. (All subjects scored above 24 at baseline, with the average MMSE score equal to 28 in both the prevastatin group and the placebo group.)
Similarly, the Heart Protection Study, with more than 20,000 subjects, also failed to show any effect of simvastatin (Zocor) on cognitive function.
Shepherd noted that while observational studies have suggested that statins can reduce the risk of dementia, neither small, randomized, placebo-controlled studies nor large-scale clinical trials have confirmed any benefit.
Related Article:
-
Cholesterol Metabolism May Provide Alzheimer’s Clue
- Jim Rosack
Psychiatr News 2003 38: 30-52.
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