Purpose
In our initial study of the potential effects of cholesterol-lowering interventions
on cognitive functioning, treatment with lovastatin as compared with placebo caused
performance decrements on several neuropsychological tests, whereas scores on other
tests were unaffected. The current study was designed to confirm and extend those
findings.
Methods
The study comprised 308 hypercholesterolemic adults between 35 and 70 years of age.
Employing a randomized double-blind design, we assigned participants to daily treatment
with placebo, 10 mg of simvastatin, or 40 mg of simvastatin for 6 months. A neuropsychological
test battery was administered to assess cognitive functioning at baseline and at the
end of the treatment period.
Results
A total of 283 subjects completed the study: 94 subjects on placebo, 96 taking 10
mg of simvastatin, and 93 taking 40 mg of simvastatin. Compared with placebo, decremental
effects of simvastatin treatment were found on tests previously observed to be sensitive
to statins (P = 0.008; difference in summary z scores = 0.18; 95% confidence interval [CI]: 0.07 to 0.29) and on tests not previously
administered (P = 0.04; difference in summary z scores = 0.17; 95% CI: 0.05 to 0.29), but not on tests previously observed to be
insensitive to statins (P = 0.84; difference in summary z scores = 0.02; 95% CI: -0.07 to 0.10). For the three tests specifically affected
by simvastatin, effects on cognitive performance were small, manifest only as failure
to improve during the 6 months of treatment (compared with placebo), and were confounded
by baseline differences on one test.
Conclusion
This study provides partial support for minor decrements in cognitive functioning
with statins. Whether such effects have any long-term sequelae or occur with other
cholesterol-lowering interventions is not known.
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Article info
Publication history
Accepted:
July 26,
2004
Received:
February 17,
2004
Footnotes
This research was supported by National Institutes of Health Public Health Service grant HL46328.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
