Catriona Reddin, Aidan Stankard, Kei Yen Chan, Finn Krewer, Conor Judge, Michelle Canavan, Daniel H J Davis, Martin O'Donnell
{"title":"降脂治疗与痴呆和认知结局的关联:一项系统回顾和荟萃分析。","authors":"Catriona Reddin, Aidan Stankard, Kei Yen Chan, Finn Krewer, Conor Judge, Michelle Canavan, Daniel H J Davis, Martin O'Donnell","doi":"10.1093/ageing/afaf219","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Lipid-lowering agents are effective in reducing cardiovascular risk, but their effect on cognitive impairment and dementia is uncertain. The aim of this meta-analysis was to determine whether lipid-lowering therapy, compared to control, was associated with a reduction in risk of dementia or cognitive impairment.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of randomised controlled trials comparing lipid-lowering therapy to control that reported dementia or change in cognitive scores, adhering to the Cochrane Collaboration Guidelines. A random effects meta-analysis was used to estimate a pooled treatment-effect. The primary outcome measure was incident cognitive impairment or dementia.</p><p><strong>Results: </strong>Twenty randomised controlled trials were eligible for inclusion, 15 trials (n = 139 169 participants) reported dementia or cognitive impairment on follow-up (primary outcome) and nine trials (n = 32 370) reported on change in cognitive score. The mean (SD) age of trial participants was 65.4 (5.06) years in the intervention arm and 65.4 (5.03) in the control arm. Lipid-lowering therapy compared with control was not associated with a significant reduction in dementia or cognitive impairment (1.33% vs 1.36% over a mean trial follow-up of 34.5 months; Odds Ratio, 0.96; 95% CI, 0.74-1.26). Heterogeneity was moderate (I2 = 37.6%). There was no significant association amongst drug classes (Statin; OR 0.90; 95% CI, 0.67-1.21, PCSK9 inhibitor: OR 1.77; 95% CI, 0.46-6.83, Other: OR 0.85; 0.61-1.17).</p><p><strong>Discussion: </strong>In this meta-analysis of over 100 000 participants, lipid-lowering therapy was not significantly associated with a lower risk of incident cognitive impairment or dementia. This meta-analysis provides evidence to support the safety of lipid-lowering therapy on cognitive health, however, does not provide evidence of risk reduction of incident cognitive impairment or dementia.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341882/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of lipid-lowering therapy with dementia and cognitive outcomes: a systematic review and meta-analysis.\",\"authors\":\"Catriona Reddin, Aidan Stankard, Kei Yen Chan, Finn Krewer, Conor Judge, Michelle Canavan, Daniel H J Davis, Martin O'Donnell\",\"doi\":\"10.1093/ageing/afaf219\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>Lipid-lowering agents are effective in reducing cardiovascular risk, but their effect on cognitive impairment and dementia is uncertain. The aim of this meta-analysis was to determine whether lipid-lowering therapy, compared to control, was associated with a reduction in risk of dementia or cognitive impairment.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of randomised controlled trials comparing lipid-lowering therapy to control that reported dementia or change in cognitive scores, adhering to the Cochrane Collaboration Guidelines. A random effects meta-analysis was used to estimate a pooled treatment-effect. The primary outcome measure was incident cognitive impairment or dementia.</p><p><strong>Results: </strong>Twenty randomised controlled trials were eligible for inclusion, 15 trials (n = 139 169 participants) reported dementia or cognitive impairment on follow-up (primary outcome) and nine trials (n = 32 370) reported on change in cognitive score. The mean (SD) age of trial participants was 65.4 (5.06) years in the intervention arm and 65.4 (5.03) in the control arm. Lipid-lowering therapy compared with control was not associated with a significant reduction in dementia or cognitive impairment (1.33% vs 1.36% over a mean trial follow-up of 34.5 months; Odds Ratio, 0.96; 95% CI, 0.74-1.26). Heterogeneity was moderate (I2 = 37.6%). There was no significant association amongst drug classes (Statin; OR 0.90; 95% CI, 0.67-1.21, PCSK9 inhibitor: OR 1.77; 95% CI, 0.46-6.83, Other: OR 0.85; 0.61-1.17).</p><p><strong>Discussion: </strong>In this meta-analysis of over 100 000 participants, lipid-lowering therapy was not significantly associated with a lower risk of incident cognitive impairment or dementia. This meta-analysis provides evidence to support the safety of lipid-lowering therapy on cognitive health, however, does not provide evidence of risk reduction of incident cognitive impairment or dementia.</p>\",\"PeriodicalId\":7682,\"journal\":{\"name\":\"Age and ageing\",\"volume\":\"54 8\",\"pages\":\"\"},\"PeriodicalIF\":7.1000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341882/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Age and ageing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ageing/afaf219\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Age and ageing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ageing/afaf219","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Association of lipid-lowering therapy with dementia and cognitive outcomes: a systematic review and meta-analysis.
Background and objectives: Lipid-lowering agents are effective in reducing cardiovascular risk, but their effect on cognitive impairment and dementia is uncertain. The aim of this meta-analysis was to determine whether lipid-lowering therapy, compared to control, was associated with a reduction in risk of dementia or cognitive impairment.
Methods: We performed a systematic review and meta-analysis of randomised controlled trials comparing lipid-lowering therapy to control that reported dementia or change in cognitive scores, adhering to the Cochrane Collaboration Guidelines. A random effects meta-analysis was used to estimate a pooled treatment-effect. The primary outcome measure was incident cognitive impairment or dementia.
Results: Twenty randomised controlled trials were eligible for inclusion, 15 trials (n = 139 169 participants) reported dementia or cognitive impairment on follow-up (primary outcome) and nine trials (n = 32 370) reported on change in cognitive score. The mean (SD) age of trial participants was 65.4 (5.06) years in the intervention arm and 65.4 (5.03) in the control arm. Lipid-lowering therapy compared with control was not associated with a significant reduction in dementia or cognitive impairment (1.33% vs 1.36% over a mean trial follow-up of 34.5 months; Odds Ratio, 0.96; 95% CI, 0.74-1.26). Heterogeneity was moderate (I2 = 37.6%). There was no significant association amongst drug classes (Statin; OR 0.90; 95% CI, 0.67-1.21, PCSK9 inhibitor: OR 1.77; 95% CI, 0.46-6.83, Other: OR 0.85; 0.61-1.17).
Discussion: In this meta-analysis of over 100 000 participants, lipid-lowering therapy was not significantly associated with a lower risk of incident cognitive impairment or dementia. This meta-analysis provides evidence to support the safety of lipid-lowering therapy on cognitive health, however, does not provide evidence of risk reduction of incident cognitive impairment or dementia.
期刊介绍:
Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.