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。

IF 7.1 2区 医学 Q1 GERIATRICS & GERONTOLOGY
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}
引用次数: 0

摘要

背景与目的:降脂药物可有效降低心血管风险,但其对认知障碍和痴呆的影响尚不确定。这项荟萃分析的目的是确定与对照组相比,降脂治疗是否与痴呆或认知障碍风险的降低有关。方法:我们遵循Cochrane协作指南,对随机对照试验进行了系统回顾和荟萃分析,比较了降脂治疗与对照组报告的痴呆或认知评分变化。随机效应荟萃分析用于估计综合治疗效果。主要结局指标是认知障碍或痴呆的发生率。结果:20项随机对照试验符合纳入条件,15项试验(n = 139,169名受试者)在随访中报告了痴呆或认知障碍(主要结局),9项试验(n = 32,370)报告了认知评分的变化。试验参与者的平均(SD)年龄在干预组为65.4(5.06)岁,在对照组为65.4(5.03)岁。与对照组相比,降脂治疗与痴呆或认知障碍的显著减少无关(在平均34.5个月的试验随访中,1.33% vs 1.36%;优势比,0.96;95% ci, 0.74-1.26)。异质性为中等(I2 = 37.6%)。药物类别间无显著关联(他汀类药物;或0.90;95% CI, 0.67-1.21, PCSK9抑制剂:OR 1.77;95% CI, 0.46-6.83,其他:OR 0.85;0.61 - -1.17)。讨论:在这项超过10万名参与者的荟萃分析中,降脂治疗与降低认知障碍或痴呆的风险没有显著相关性。本荟萃分析提供了证据支持降脂治疗对认知健康的安全性,但没有提供证据表明降低认知障碍或痴呆的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信