[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 50.16.5.192. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 14,305
Citations 0
Original Investigation
December 12, 2016

Sex and Race Differences in the Association Between Statin Use and the Incidence of Alzheimer Disease

Author Affiliations
  • 1Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles
  • 2Center for Innovation in Brain Science, University of Arizona Health Sciences, Tucson
JAMA Neurol. Published online December 12, 2016. doi:10.1001/jamaneurol.2016.3783
Key Points

Question  What is the association between statin use and the incidence of Alzheimer disease among male and female Medicare beneficiaries?

Findings  In this study, high vs low exposure to statins was associated with a lower incidence of Alzheimer disease for women and men, respectively. The reduction in incidence of Alzheimer disease varied across race/ethnicity and type of statin.

Meaning  Statins may potentially affect Alzheimer disease risk, so physicians should consider which statin is prescribed to their patients.

Abstract

Importance  To our knowledge, no effective treatments exist for Alzheimer disease, and new molecules are years away. However, several drugs prescribed for other conditions have been associated with reducing its risk.

Objective  To analyze the association between statin exposure and Alzheimer disease incidence among Medicare beneficiaries.

Design, Setting, and Participants  We examined the medical and pharmacy claims of a 20% sample of Medicare beneficiaries from 2006 to 2013 and compared rates of Alzheimer disease diagnosis for 399 979 statin users 65 years of age or older with high or low exposure to statins and with drug molecules for black, Hispanic, and non-Hispanic white people, and men and women of Asian, Native American, or unkown race/ethnicity who are referred to as “other.”

Main Outcomes and Measures  The main outcome was incident diagnosis of Alzheimer disease based on the International Classification of Diseases, Ninth Revision, Clinical Modification. We used Cox proportional hazard models to analyze the association between statin exposure and Alzheimer disease diagnosis for different sexes, races and ethnicities, and statin molecules.

Results  The 399 979 study participants included 7794 (1.95%) black men, 24 484 (6.12%) black women, 11 200 (2.80%) Hispanic men, 21 458 (5.36%) Hispanic women, 115 059 (28.77%) white men, and 195 181 (48.80%) white women. High exposure to statins was associated with a lower risk of Alzheimer disease diagnosis for women (hazard ratio [HR], 0.85; 95% CI, 0.82-0.89; P<.001) and men (HR, 0.88; 95% CI, 0.83-0.93; P<.001). Simvastatin was associated with lower Alzheimer disease risk for white women (HR, 0.86; 95% CI, 0.81-0.92; P<.001), white men (HR, 0.90; 95% CI, 0.82-0.99; P=.02), Hispanic women (HR, 0.82; 95% CI, 0.68-0.99; P=.04), Hispanic men (HR, 0.67; 95% CI, 0.50-0.91; P=.01), and black women (HR, 0.78; 95% CI, 0.66-0.93; P=.005). Atorvastatin was associated with a reduced risk of incident Alzheimer disease diagnosis for white women (HR, 0.84, 95% CI, 0.78-0.89), black women (HR, 0.81, 95% CI, 0.67-0.98), and Hispanic men (HR, 0.61, 95% CI, 0.42-0.89) and women (HR, 0.76, 95% CI, 0.60-0.97). Pravastatin and rosuvastatin were associated with reduced Alzheimer disease risk for white women only (HR, 0.82, 95% CI, 0.70-0.95 and HR, 0.81, 95% CI, 0.67-0.98, respectively). High statin exposure was not associated with a statistically significant lower Alzheimer disease risk among black men.

Conclusions and Relevance  The reduction in Alzheimer disease risk varied across statin molecules, sex, and race/ethnicity. Clinical trials that include racial and ethnic groups need to confirm these findings. Because statins may affect Alzheimer disease risk, physicians should consider which statin is prescribed to each patient.

×