OBJECTIVES: Alzheimer’s disease and related dementias comprise a class of fatal neurodegenerative conditions with few costly treatment options of dubious efficacy. In contrast, HMGCR inhibitors, or statins, comprise a well-established, low-cost class of effective treatments for dyslipidemia. As ADRD is thought to be an outcome of excessive cerebral Aꞵ aggregation triggered by dyslipidemia, statins are also believed to offer prophylaxis against ADRD. The objective of this analysis was to assess whether statins significantly reduce ADRD risk among older adults and, if so, which statin drugs offer the greatest risk reduction.

METHODS: A retrospective matched case-control analysis was conducted using 2019-2020 Medicare Current Beneficiary Survey data. Eligible cases of ADRD were identified via the MCBS Health Status Functioning Questionnaire and the Health Status section of the MCBS Facility Instrument. Each eligible case was matched with two controls based on sex, race, nationality, age stratum, and income level; respondents <45 and those missing corresponding prescription data were excluded. Statin use among included cases and controls was determined via the MCBS Prescription Medication Utilization Questionnaire. Associations between statin use and ADRD diagnosis were assessed via Fisher’s exact test using SAS® v9.4.

RESULTS: Statin use was found to significantly reduce risk of ADRD diagnosis (OR 0.68, 95% CI: 0.59-0.78; p<0.0001). Among individual statins, rosuvastatin was found to be significantly more effective at reducing ADRD risk than atorvastatin (OR 0.66, 95% CI: 0.47-0.94; p=0.0193). Hydrophilic statins were also found to be significantly more effective at reducing ADRD risk than lipophilic statins (OR 0.77, 95% CI: 0.60-0.98; p=0.0394).

CONCLUSIONS: Statin use was found to significantly reduce ADRD risk among the analyzed cohort of older adults. However, future longitudinal research remains necessary to confirm that statins are indeed an effective prophylaxis against ADRD.