statins and cognitive decline

[eml256]

How is the following study reported to "show promising results" when
the outcome was that initial use of statins resulted in less
cognitive
decline in individuals, but continued use of a statin resulted in
MORE
cognitive decline.
Predictably, initial use of statins should be of benefit in any
disease that includes an inflammatory process--as most of all the
neurodegenerative diseases are theorized to include. Statins are
powerful anti-inflammatory agents, and initially should decrease this
aspect of any disease. With continued use, the other "pleiotrophic"
effects become evident: these pleiotrophic effects are mainly the
result of depression in isoprenoid biosynthesis leading to impairment
of the production of a variety of metabolic substrates such as
dolichols, crucial for N-linked glycosylation; geranylgeranyl
pyrophosphate, necessary for coenzyme Q10; farnesyl-pyrophosphate,
necessary for the maturation of prelamin A and B-type lamins and G-
proteins ;and isopentenylpyrophosphate, involved in direct
modification of selenocysteinyl-tRNA and thus indirectly related to
the synthesis of all selenoproteins (last estimated at 35).
(glutathione reductase is depleted by statins--this substance is
responsible for recycling glutathione in the brain)
Important to remember: brain cholesterol has a half-life of ~5yrs.
Fat
soluble statins, Lipitor, zocor, crestor, all cross the blood brain
barrier and thus are able to affect the level of brain cholesterol.
If
a critical level of cholesterol exists for the brain, more time than
a
2 to 3 yr period normally used in clinical trials would be necessary
to appreciate the effects of lowering cholesterol levels in the
brain.

Study Of Relationship Between Statins And Cognitive Decline


06 Nov 2007
*http://www.medicalnewstoday.com/articles/87841.php


Previous explorations of a link between statins, a cholesterol
lowering medication, and cognitive decline have produced inconsistent
results. New research reveals that the relationship between statin
use
and cognitive decline appears even more complex than had been
thought.


In a three year epidemiological study, researchers from the Indiana
University School of Medicine and the Regenstrief Institute, Inc.
have
found an association of statin use with less cognitive decline in
elderly African Americans and report that, surprisingly, the
association is even stronger for those who had discontinued use than
for continuous users. Their findings are published in the Nov. 6
issue
of Neurology.


In 2001 and again in 2004, the IU School of Medicine researchers
evaluated 1146 African Americans aged 70 and older living in
Indianapolis testing them in various cognitive areas including
language, attention and calculation, memory and orientation. The
researchers also compared use of statins and whether, if used, they
were taken consistently. While cognitive decline in statin users was
less than those who did not take statins, those who continued to take
statins from 2001 to 2004 had greater cognitive decline than those
who
were taking statins in 2001 but were no longer taking them in 2004.
Study participants who discontinued statin use did not differ from
those who continued to use statins in any other health, demographic,
clinical or biochemical characteristics.


If statin use were directly associated with a reduction in cognitive
decline, continuously taking statins would presumably produce the
greatest effect. The study authors say that in light of their
findings
that the association between statins and decreased cognitive decline
is more complex than previously realized, carefully designed
randomized clinical trials of statins are needed to provide
definitive
answers to their potential role in dementia prevention.


"Statin use plays an important role in the prevention of
cardiovascular disease. And there may be a link between
cardiovascular
risk factors and risk factors for cognitive decline and Alzheimer
disease. This is just one area that needs to be explored," said
Kathleen S. Hall, Ph.D, senior author of the study. A psychiatric
epidemiologist, she is an associate professor of psychiatry at the IU
School of Medicine and an affiliated scientist of the Regenstrief
Institute.


Dr. Hall is the principal investigator of the Indianapolis -- Ibadan
comparative epidemiological project, a study designed to identify
potentially modifiable risk factors for Alzheimer disease by
comparing
the disease in two populations from a developed and developing
country--African Americans living in Indianapolis and Yoruba living
in
Ibadan, Nigeria.


"We know that taking statin medication can protect against
cardiovascular events such as heart attacks by lowering blood
cholesterol. The question at hand is what effects do these
medications
have on brain function. Our study along with others shows promising
results but larger controlled studies are needed," said Stanley
Szwast, M.D., a fourth year psychiatry resident at the Indiana
University School of Medicine and first author of the study.

[Brian C.]

Statins are, by their very nature, incapacitating agents.
That's all we need to know.
All else is noise.

Brian.

[mags]

Well said Brian!!