Dementia is a general term for a majority of the types of disorders that damage memory, thinking, and the ability to perform daily activities. The World Health Organization (WHO) reported that there are currently more than 55 million people who have dementia in the world, with over 60% of them being in low-and middle-income countries. Every year, there are nearly 10 million new cases, and the current disease incidence is likely to triple by 2050.

Dementia can have many etiologies. With Alzheimer’s disease being the most common (60–70%), vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are also behind many of the cases.

It has been exemplified that Statins, generally used for cardiovascular advantages, may also exert neuroprotective effects. A new Brazilian study, being the largest meta-analysis to date on statins and dementia risk to date, with an unprecedented pool of 7 million patients and around 55 observational studies, including detailed analyses of some key factors that could play a key role in the results, such as gender, the duration of exposure, type of statin, and geographic region amongst others. This approach allows for a more detailed and thorough analysis of the link between the two.

This study yielded the following key findings:

● There was a 32 percent reduction in the overall risk of developing dementia, Alzheimer’s Disease, and Vascular Dementia when statins were used.

● Longer exposure durations were found to have stronger protective effects as patients who used more than three years of Statin therapy came across a 63% reduction in dementia risk, which is significant from a statistical point of view.

● Different types of statins have been tested (simvastatin, lovastatin, pravastatin, fluvastatin, atorvastatin, rosuvastatin, and pitavastatin), and Rosuvastatin had the greatest risk reduction for dementia, around 28%.

● Though Dementia is more common in females, men had a slightly higher decrease in dementia risk. While Atorvastatin was the only statin reaching statistical significance among male patients, Rosuvastatin resulted in the most significant reduction of risk among female patients.

● Geographic variation was more marked in Asia and America. This could be the result of especially high prevalence rates in those populations compared to other populations such as Africa and Europe, of modifiable cardiovascular risk factors like hypertension, diabetes, and dyslipidemia, added to different prescription habits among different countries.

The pharmacological properties, especially the capacity of statins to cross the blood-brain barrier (BBB) and subsequently affect the CNS, are important modulators of differential effects on neurodegeneration. Lipophilic statins, such as atorvastatin and simvastatin, owing to greater passive diffusion across cellular membranes, allow the significant penetration of BBB. This particular property enables it to act directly on cholesterol metabolism within the brain, amyloid-beta processing, and neuroinflammation.

In addition, statins are low-cost medications and thus have great potential in dementia prevention, especially in low and middle‐income countries where the majority of dementia sufferers reside. The accessibility and affordability of statins, together with our findings of risk reduction in all dementia, AD, and VaD patients, present statins as a good candidate for large‐scale public health interventions to reduce the global burden of neurodegenerative diseases, contributing greatly to the future global health landscape.

References:

1.     World Health Organization . Dementia WHO. World Health Organization

2.  Westphal Filho FL, Moss Lopes PR, Menegaz de Almeida A, Sano VKT, Tamashiro FM, Gonçalves OR, de Moraes FCA, Kreuz M, Kelly FA, Silveira Feitoza PV. Statin use and dementia risk: A systematic review and updated meta-analysis. Alzheimers Dement (N Y). 2025 Jan 16;11(1):e70039. doi: 10.1002/trc2.70039. PMID: 39822593; PMCID: PMC11736423