On any given day there are enough spurious headlines being reported about advances in Alzheimer's Disease diagnosis, treatment, or curative strategies to keep me writing around the clock. I realize that quite often well-meaning societies or research groups are just trying to sprinkle a bit of hope among the patients and their families at risk, diagnosed, or even in the final days.
Unfortunately the impact is more like watching one of the old Godzilla movies--the good ones where the dubbing has the actual dialogue distorted by the out of sync mouth movements. Or to quote Calvin, from Calvin and Hobbes ""I wonder why Japanese people keep moving their mouths when they're through talking."
Unfortunately the impact is more like watching one of the old Godzilla movies--the good ones where the dubbing has the actual dialogue distorted by the out of sync mouth movements. Or to quote Calvin, from Calvin and Hobbes ""I wonder why Japanese people keep moving their mouths when they're through talking."
The Bad & The Good in Statins & Alzheimers
I pulled this recent article from my newsfeed on April 15th, 2015. As always I read through the data with an arched eyebrow of skepticism while also trying to see if there is anything that supports the bold claims in the leading paragraph. The first and only link to literature in the article, Statin-associated memory loss: analysis of 60 case reports and review of the literature links to a study from 2003. Conclusions in this study were inconclusive and report the following...
Current literature is conflicting with regard to the effects of statins on memory loss. Experimental studies support links between cholesterol intake and amyloid synthesis; observational studies indicate that patients receiving statins have a reduced risk of dementia. However, available prospective studies show no cognitive or antiamyloid benefits for any statin. In addition, case reports raise the possibility that statins, in rare cases, may be associated with cognitive impairment, though causality is not certain.
Research in the literature has described cholesterol-lowering and pleiotropic properties of statins in vivo and in vitro models. The prevailing truth states that the "effects of statins in the brain are broad and complex and that their use for treating several diseases including AD should be carefully analyzed given their multiple and broad effects". These findings will be reported in future blogs.
Research in the literature has described cholesterol-lowering and pleiotropic properties of statins in vivo and in vitro models. The prevailing truth states that the "effects of statins in the brain are broad and complex and that their use for treating several diseases including AD should be carefully analyzed given their multiple and broad effects". These findings will be reported in future blogs.
The article in Alzheimer's & Dementia Weekly presents findings without linking to the data from the study but the claims alone are quite interesting especially in the absence of how the data was calculated. I tried to dig up details of the 2013 study that yielded these compelling claims but so far--nothing.
High doses of statins prevent dementia in older people, according to research presented at the ESC Congress by Dr. Tin-Tse Lin from Taiwan. The study of nearly 58,000 patients found that high potency statins had the strongest protective effects against dementia.
Dr. Lin said: “Statins are widely used in the older population to reduce the risk of cardiovascular disease. But recent reports of statin-associated cognitive impairment have led the US Food and Drug Administration (FDA) to list statin-induced cognitive changes, especially for the older population, in its safety communications.”
Dr. Lin said: “Statins are widely used in the older population to reduce the risk of cardiovascular disease. But recent reports of statin-associated cognitive impairment have led the US Food and Drug Administration (FDA) to list statin-induced cognitive changes, especially for the older population, in its safety communications.”
The adjusted hazard ratios (HRs) for dementia were significantly inversely associated with increased daily or total equivalent statin dosage. The HRs for the three tertiles of mean equivalent daily dosage (lowest to highest) were 0.622, 0.697 and 0.419 vs control (p<0.001 for trend). The HRs for the three tertiles of total equivalent dosage (lowest to highest) were 0.773, 0.632 and 0.332 vs control (p<0.001 for trend). The protective effect of statins remained in different age, gender and cardiovascular risk subgroups.
Dr. Lin said: “The adjusted risks for dementia were significantly inversely associated with increased total or daily equivalent statin dosage. Patients who received the highest total equivalent doses of statins had a 3-fold decrease in the risk of developing dementia. Similar results were found with the daily equivalent statin dosage.”
Dr. Lin said: “The adjusted risks for dementia were significantly inversely associated with increased total or daily equivalent statin dosage. Patients who received the highest total equivalent doses of statins had a 3-fold decrease in the risk of developing dementia. Similar results were found with the daily equivalent statin dosage.”
So what does it all mean?
A simplistic definition of a hazard ratio means that a value of 1 reports no difference between the two comparative groups. In its simplest form the hazard ratio can be interpreted as the chance of an event occurring in the treatment arm divided by the chance of the event occurring in the control arm, or vice versa, of a study. The hazard ratio greater than one indicates that the measured event is happening faster for the treatment group than for the control group. A hazard ratio less than one indicates that the event of interest is happening slower for the treatment group than for the control group. These values would mean in the context of hazard ratio, “slow” means that a treated patient is compared at the next point in time compared to someone in the control group. Coincedentally I did find the cartoon selection in the article to seem out of sync with the rest of the article--bringing me back to the out of date audio dubs of the 60s and 70s. In the absence of additional data to reveal or contextualize the selected statistical models there is nothing to see here.
