Los Angeles—High use of statins is generally associated with a reduced risk for Alzheimer’s disease (AD), but the effect varied significantly by product, as well as by race and ethnicity, according to an analysis of Medicare data.

The report, published online by JAMA Neurology, notes that previous research has suggested a protective association between statins and AD. To further examine the effect, a study team led by University of Southern California researchers analyzed claims data from a final sample of nearly 400,0000 Medicare beneficiaries who used the cholesterol-lowering medications.

To examine the association of statin use and the onset of AD, researchers looked at high and low exposure to statins and statin type for the four most commonly prescribed statins: simvastatin, atorvastatin, pravastatin, and rosuvastatin.

Results indicate that, from 2009 to 2013, 1.72% of women and 1.32% of men received a diagnosis of AD annually, with white men having the lowest incidence of 1.23%.

The average annual number of days of statin use was lower for black and Hispanic individuals than for white individuals. That was significant, because high exposure to statins—defined as at least the 50th percentile of days of filled prescriptions in a given year for at least 2 years, from 2006 through 2008—was associated with a decreased risk of AD of 15% for women and 12% for men.

The association between statins and AD varied across race/ethnicity and sex, according to the report: While the risk was reduced for Hispanic men, white women and men, and black women, no significant difference in risk was seen for black men who had high exposure to statins compared with low exposure.

More specifically, while high exposure to simvastatin was associated with a lower risk of AD for white, Hispanic, and black women, as well as white and Hispanic men, no reduction in AD risk for black men was associated with any statin.

Study authors report that atorvastatin was associated with reduced AD risk among white, black, and Hispanic women, as well as Hispanic men, and that both pravastatin and rosuvastatin were associated with reduced AD risk for white women.

The researchers emphasize that their study cannot establish causality and call for clinical trials, including participants from all racial and ethnic groups, to confirm the findings.

“This suggests that certain patients, facing multiple, otherwise equal statin alternatives for hyperlipidemia treatment, may reduce AD risk by using a particular statin,” study authors conclude. “The right statin type for the right person at the right time may provide a relatively inexpensive means to lessen the burden of AD.”

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