|Title||Sex and Race Differences in the Association Between Statin Use and the Incidence of Alzheimer Disease.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Zissimopoulos JM, Barthold D, Brinton RDiaz, Joyce G|
|Date Published||2017 Feb 01|
|Keywords||African Continental Ancestry Group, Aged, Aged, 80 and over, Alzheimer Disease, Asian Americans, European Continental Ancestry Group, Female, Hispanic Americans, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Incidence, Longitudinal Studies, Male, Medicare, Proportional Hazards Models, Psychiatric Status Rating Scales, Retrospective Studies, Sex Characteristics, United States|
Importance: To our knowledge, no effective treatments exist for Alzheimer disease, and new molecules are years away. However, several drugs prescribed for other conditions have been associated with reducing its risk.
Objective: To analyze the association between statin exposure and Alzheimer disease incidence among Medicare beneficiaries.
Design, Setting, and Participants: We examined the medical and pharmacy claims of a 20% sample of Medicare beneficiaries from 2006 to 2013 and compared rates of Alzheimer disease diagnosis for 399 979 statin users 65 years of age or older with high or low exposure to statins and with drug molecules for black, Hispanic, and non-Hispanic white people, and men and women of Asian, Native American, or unkown race/ethnicity who are referred to as "other."
Main Outcomes and Measures: The main outcome was incident diagnosis of Alzheimer disease based on the International Classification of Diseases, Ninth Revision, Clinical Modification. We used Cox proportional hazard models to analyze the association between statin exposure and Alzheimer disease diagnosis for different sexes, races and ethnicities, and statin molecules.
Results: The 399 979 study participants included 7794 (1.95%) black men, 24 484 (6.12%) black women, 11 200 (2.80%) Hispanic men, 21 458 (5.36%) Hispanic women, 115 059 (28.77%) white men, and 195 181 (48.80%) white women. High exposure to statins was associated with a lower risk of Alzheimer disease diagnosis for women (hazard ratio [HR], 0.85; 95% CI, 0.82-0.89; P<.001) and men (HR, 0.88; 95% CI, 0.83-0.93; P<.001). Simvastatin was associated with lower Alzheimer disease risk for white women (HR, 0.86; 95% CI, 0.81-0.92; P<.001), white men (HR, 0.90; 95% CI, 0.82-0.99; P=.02), Hispanic women (HR, 0.82; 95% CI, 0.68-0.99; P=.04), Hispanic men (HR, 0.67; 95% CI, 0.50-0.91; P=.01), and black women (HR, 0.78; 95% CI, 0.66-0.93; P=.005). Atorvastatin was associated with a reduced risk of incident Alzheimer disease diagnosis for white women (HR, 0.84, 95% CI, 0.78-0.89), black women (HR, 0.81, 95% CI, 0.67-0.98), and Hispanic men (HR, 0.61, 95% CI, 0.42-0.89) and women (HR, 0.76, 95% CI, 0.60-0.97). Pravastatin and rosuvastatin were associated with reduced Alzheimer disease risk for white women only (HR, 0.82, 95% CI, 0.70-0.95 and HR, 0.81, 95% CI, 0.67-0.98, respectively). High statin exposure was not associated with a statistically significant lower Alzheimer disease risk among black men.
Conclusions and Relevance: The reduction in Alzheimer disease risk varied across statin molecules, sex, and race/ethnicity. Clinical trials that include racial and ethnic groups need to confirm these findings. Because statins may affect Alzheimer disease risk, physicians should consider which statin is prescribed to each patient.
|Alternate Journal||JAMA Neurol|
|Grant List||R34 AG049652 / AG / NIA NIH HHS / United States|
Sex and Race Differences in the Association Between Statin Use and the Incidence of Alzheimer Disease.
Faculty Member Reference:
Roberta Diaz Brinton, Ph.D