Can Statins Protect Against Dementia?

Statins are widely recognized for their ability to lower cholesterol levels and reduce cardiovascular risks, but researchers are increasingly exploring whether these medications might also support brain health.

A recent meta-analysis from Brazil sheds light on this possibility. Analyzing data from 55 observational studies and 7 million patients, researchers found that taking statins was linked to a lower risk of developing Alzheimer’s disease and dementia.

“While it is too early to prescribe statins solely for dementia prevention, their potential benefits—combined with their widespread use and affordability—underscore the importance of continued research into their role in neuroprotection,” said Fernando Luiz Westphal Filho, MS, lead author of the study and neurology assistant at the Federal University of Amazonas in Brazil.

The research revealed that individuals who used statins for at least three years experienced a 63% reduction in dementia risk. Westphal Filho stressed that long-term use of statins may be necessary to achieve significant cognitive protection.

Heart and Brain Health: A Vital Connection  

Evidence continues to highlight the connection between cardiovascular health and brain function. According to a 2022 scientific statement from the American Heart Association (AHA), conditions like heart disease and high blood pressure can impair blood flow to the brain and lead to cognitive decline. People with heart disease face a 27% higher risk of developing dementia compared to those without it.

Statins work by lowering cholesterol and improving blood vessel function, which boosts blood flow to the brain, explained Paul Schulz, MD, director of the Neurocognitive Disorders Center at UTHealth Houston. “Blood flow may be important for removing amyloid plaques,” said Schulz. These plaques build up in the brains of people with Alzheimer’s disease, harming cell communication and brain function. Some FDA-approved Alzheimer’s medications target these plaques to slow the disease’s progression.

In addition to improving blood flow, statins may also reduce inflammation, another contributor to nerve cell damage in Alzheimer’s disease. “Adjusting inflammatory pathways is another way statins could promote neuroprotection,” noted Westphal Filho.

Potential Risks: Statins and Cognitive Challenges  

Despite their benefits, some concerns have been raised about statins’ impact on cognitive health. A 2021 study observed that lipophilic statins—medications that easily cross cell membranes—might slightly increase dementia risk in people without high cholesterol but with mild cognitive impairment.

According to Daniel H. Silverman, MD, PhD, at UCLA Medical Center, this risk is likely due to the lack of cholesterol-lowering benefits in patients with already low cholesterol levels. He emphasized the need for patients in this situation to discuss with their healthcare providers whether the medication's risks outweigh the benefits.

Statins have also been linked to reports of memory loss or confusion, prompting a 2012 warning from the Food and Drug Administration (FDA). These reports, collected via the FDA’s MedWatch platform, spurred research into the issue, but most studies have not uncovered strong evidence supporting these cognitive side effects.

The FDA clarified that memory loss appears to be rare and temporary, with symptoms typically resolving after discontinuing statin use. In fact, Karen Alexander, MD, a cardiologist at Duke Health, noted that statins may help reduce vascular cognitive impairment, which is caused by blood vessel damage and frequently coexists with other types of dementia.

Looking Ahead: The Promise of Clinical Trials  

Currently, most studies on statins and cognitive health are observational, which lack the rigor of randomized controlled trials—the gold standard of medical research. To close this gap, two major trials, STAREE and PREVENTABLE, are underway to explore how statins influence dementia risk.

Karen Alexander, who serves as principal investigator for the PREVENTABLE study, shared that thousands of participants are enrolled in these trials. Thus far, no evidence has emerged indicating substantial cognitive harm from statins, as the studies continue under the oversight of safety monitoring boards.

“Stay tuned in the coming two to three years for more information from these likely definitive studies,” Alexander said.

This exciting research underscores the potential neuroprotective benefits of statins, adding new dimensions to their role in supporting overall health and preventing age-related conditions.